# PSYCHIATRIC BEHAVIORAL WELLNESS

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

## Provider details

- **NPI number:** 1629933924
- **Authorized official:** MR. REVMAX TECHNOLOGIES (ENROLLMENT MANAGER)
- **Authorized official phone:** (720) 784-9413

## Contact information

- **Practice address:** 3556 DARTMOUTH LN, ROWLAND HGHTS, CA 91748-5136
- **Practice address phone:** (562) 304-5150
- **Practice address fax:** (565) 623-1710
- **Mailing address:** 3556 DARTMOUTH LN, ROWLAND HGHTS, CA 91748-5136
- **Mailing address phone:** (562) 304-5150
- **Mailing address fax:** (565) 623-1710

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 12/18/2025
- **Last updated:** 12/18/2025