Organization
PASSAGES MALIBU PHP, LLC
Active
Other names
Passages Venice
Organization subpart
No
Provider details
NPI number
Authorized official
MARINA JO MAHONEY (COO)
(310) 589-2880
Entity
Organization
Contact information
Practice address
1728 ABBOT KINNEY BLVD, #103, VENICE, CA 90291-4839
(866) 619-7013
Mailing address
6428 MEADOWS CT, MALIBU, CA 90265-4492
(310) 589-2880
(310) 464-6933
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
190835AP
CA
Other
Enumeration date
07/24/2015
Last updated
07/24/2015
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