# LLPMG REDLANDS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215850904
- **Authorized official:** LIBERTY OLIVE MACIAS NP (CEO)
- **Authorized official phone:** (909) 900-6465

## Contact information

- **Practice address:** 1200 CALIFORNIA ST STE 140, REDLANDS, CA 92374-2946
- **Practice address phone:** (909) 792-6262
- **Practice address fax:** (909) 550-1928
- **Mailing address:** 1200 CALIFORNIA ST STE 140, REDLANDS, CA 92374-2946
- **Mailing address phone:** (909) 792-6262
- **Mailing address fax:** (909) 550-1928

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103K00000X | Behavior Analyst | — | NULL | — |
| 103K00000X | Behavior Analyst | — | — | — |
| 103T00000X | Psychologist | — | NULL | — |
| 103T00000X | Psychologist | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 07/31/2026
- **Last updated:** 07/31/2026