Provider Demographics
NPI:1447745054
Name:AGOURA BEHAVIORAL HEALTH LLC
Entity Type:Organization
Organization Name:AGOURA BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOANN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZUNIGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-383-2702
Mailing Address - Street 1:28632 ROADSIDE DR STE 170
Mailing Address - Street 2:
Mailing Address - City:AGOURA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91301-6064
Mailing Address - Country:US
Mailing Address - Phone:805-383-2702
Mailing Address - Fax:818-698-6442
Practice Address - Street 1:28632 ROADSIDE DR STE 170
Practice Address - Street 2:
Practice Address - City:AGOURA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91301-6064
Practice Address - Country:US
Practice Address - Phone:805-383-2702
Practice Address - Fax:818-698-6442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-26
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health