Organization
PASSAGES BEVERLYWOOD LLC
Active
Parent organization
GRASSHOPPER HOUSE LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
GRASSHOPPER HOUSE LLC
Authorized official
MR. PAX PRENTISS (CEO)
(310) 589-2880
Entity
Organization
Contact information
Practice address
2370 S ROBERTSON BLVD, LOS ANGELES, CA 90034-2029
(310) 589-2880
(310) 589-2858
Mailing address
6428 MEADOWS CT, MALIBU, CA 90265-4492
(310) 589-2880
(310) 589-2858
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
12/18/2015
Last updated
12/18/2015
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