Provider Demographics
NPI:1366031627
Name:CAMBRIDGE MENTAL HEALTH MANAGEMENT, LLC
Entity Type:Organization
Organization Name:CAMBRIDGE MENTAL HEALTH MANAGEMENT, LLC
Other - Org Name:ALTER BEHAVIORAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:L
Authorized Official - Last Name:DUENSING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-877-2419
Mailing Address - Street 1:34270 PACIFIC COAST HWY STE C
Mailing Address - Street 2:
Mailing Address - City:DANA POINT
Mailing Address - State:CA
Mailing Address - Zip Code:92629-2847
Mailing Address - Country:US
Mailing Address - Phone:949-877-2419
Mailing Address - Fax:949-877-2419
Practice Address - Street 1:19402 SIERRA BELLO RD
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92603-3904
Practice Address - Country:US
Practice Address - Phone:866-648-0198
Practice Address - Fax:949-308-7789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-12
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
656620OtherTHE JOINT COMMISSION
CA306006347OtherDEPARTMENT OF SOCIAL SERVICES
CAMHBT200346OtherDEPARTMENT OF HEALTH CARE SERVICES