Organization
GILDED BRAZOS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYSON HAMPTON (OWNER)
(916) 949-3923
Entity
Organization
Contact information
Practice address
7624 MALTA DR, ROSEVILLE, CA 95678-6052
(916) 949-3923
Mailing address
7624 MALTA DR, ROSEVILLE, CA 95678-6052
(916) 949-3923
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
09/26/2025
Last updated
09/26/2025
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