Organization
MALIBU BEHAVIORAL HEALTH SERVICES INC
Active
Other names
'South California Road to Recovery'
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELIKA PANOVA PMHNP-RN, LMFT (EXECUTIVE MANAGER)
(714) 887-3816
Entity
Organization
Contact information
Practice address
7057 GASKIN PL, RIVERSIDE, CA 92506-5615
(951) 776-8869
(951) 215-0881
Mailing address
1057 E IMPERIAL HWY APT 226, PLACENTIA, CA 92870-1717
(951) 215-0881
(951) 215-0881
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
49586
CA
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
804708
CA
163WC0400X
Case Management Registered Nurse
804708
CA
324500000X
Substance Abuse Rehabilitation Facility
Primary
330128AP
CA
Other
Enumeration date
02/06/2014
Last updated
09/05/2024
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