Malibu Renewal Centre

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

MALIBU RENEWAL CENTRE

Practice address

4237 Avenida de la Encinal
Malibu, CA 90265-2501

Phone

(310) 457-6185

Fax

(877) 936-3112

NPI assigned

Jun 17, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Tami Pacheco

Title

Owner

Phone

(505) 401-4734

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1434499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434499200000",
    "number": "1760863567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4237 AVENIDA DE LA ENCINAL",
            "city": "MALIBU",
            "state": "CA",
            "postal_code": "902652501",
            "telephone_number": "310-457-6185",
            "fax_number": "877-936-3112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4237 AVENIDA DE LA ENCINAL",
            "city": "MALIBU",
            "state": "CA",
            "postal_code": "902652501",
            "telephone_number": "310-457-6185",
            "fax_number": "877-936-3112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MALIBU RENEWAL CENTRE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-17",
        "last_updated": "2015-06-17",
        "status": "A",
        "authorized_official_last_name": "PACHECO",
        "authorized_official_first_name": "TAMI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-401-4734",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Malibu Lighthouse Treatment Centers (Avalon Ranch)
• Malibu Medical Corp
• Malibu Medical Corporation
• Malibu Occupational & Speech Therapy
• Malibu Outpatient Inc
• Malibu Seaside Serenity Cove, Inc.
• Malibu TMS
• Litos O. Mallare, M.D.
• Maribel Mancillas
• Arthur Jay Margulies, JD, CADC-I

• Substance Abuse Rehabilitation Facility in Malibu, CA
• Providers in Malibu, CA by specialty
• Substance Abuse Rehabilitation Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.