Provider Demographics
NPI:1437656295
Name:DESIGN FOR LIVING BEHAVIOR HEALTH, INC.
Entity Type:Organization
Organization Name:DESIGN FOR LIVING BEHAVIOR HEALTH, INC.
Other - Org Name:CYCLES OF CHANGE RECOVERY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-497-8177
Mailing Address - Street 1:43858 BEECH AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-5007
Mailing Address - Country:US
Mailing Address - Phone:661-800-4828
Mailing Address - Fax:
Practice Address - Street 1:38700 5TH ST W STE E
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-3996
Practice Address - Country:US
Practice Address - Phone:661-800-4828
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DESIGN FOR LIVING BEHAVIOR HEALTH, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-04-09
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA190735CP324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA190735CPOtherDEPT OF HEALTH CARE SERVICES