Provider Demographics
NPI:1760090518
Name:HOTEL CALIFORNIA BY THE SEA BELLEVUE, LLC.
Entity Type:Organization
Organization Name:HOTEL CALIFORNIA BY THE SEA BELLEVUE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF PROGRAM OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BIXLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:844-766-8717
Mailing Address - Street 1:3419 VIA LIDO STE 145
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-3908
Mailing Address - Country:US
Mailing Address - Phone:844-766-8717
Mailing Address - Fax:
Practice Address - Street 1:7810 130TH AVE NE
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-8251
Practice Address - Country:US
Practice Address - Phone:844-766-8717
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOTEL CALIFORNIA BY THE SEA BELLEVUE, LLC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-07-17
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility