Organization
KLM BEHAVORIAL HEALTH
Active
Organization
KLM BEHAVORIAL HEALTH
Active
Parent organization
DEDICATO TREATMENT CENTER INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
DEDICATO TREATMENT CENTER INC
Authorized official
DR. KEITH LAMONT MARSHALL PSY.D, C.A.T.C V (CEO/CERTIFIED ADDICTION TREATMENT)
(626) 644-8857
Entity
Organization
Contact information
Practice address
222 S OAK AVE, PASADENA, CA 91107-4033
(626) 584-9502
Mailing address
222 S OAK AVE, PASADENA, CA 91107-4033
(626) 584-9502
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
091947 V
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1760753867
INSURANCE CARRIERS
CA
05
—
1760753867
—
CA
Enumeration date
11/03/2015
Last updated
11/03/2015
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