Provider Demographics
NPI:1184020398
Name:ACADIA MALIBU, INC.
Entity Type:Organization
Organization Name:ACADIA MALIBU, INC.
Other - Org Name:ACADIA MALIBU OUTPATIENT
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JARED
Authorized Official - Middle Name:
Authorized Official - Last Name:VALENTINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-579-5192
Mailing Address - Street 1:30765 PACIFIC COAST HIGHWAY #135
Mailing Address - Street 2:
Mailing Address - City:MALIBU
Mailing Address - State:CA
Mailing Address - Zip Code:90265-3643
Mailing Address - Country:US
Mailing Address - Phone:310-579-5192
Mailing Address - Fax:
Practice Address - Street 1:28955 PACIFIC COAST HIGHWAY # 200
Practice Address - Street 2:
Practice Address - City:MALIBU
Practice Address - State:CA
Practice Address - Zip Code:90265
Practice Address - Country:US
Practice Address - Phone:805-370-8048
Practice Address - Fax:310-919-3684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-16
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder