Organization
HILLSIDES
Active
Other names
Hillsides Youth Moving On
Organization subpart
No
Provider details
NPI number
Authorized official
MARISOL LARA (QA MANAGER ADMINISTRATION)
(323) 254-2274
Entity
Organization
Contact information
Practice address
456 E ORANGE GROVE BLVD STE 140, PASADENA, CA 91104-5235
(626) 765-6010
Mailing address
940 AVENUE 64, PASADENA, CA 91105-2711
(323) 254-2274
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
10/09/2024
Last updated
10/14/2025
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