Clementine Malibu Lake

LBN: Monte Nido Lake Vista, Llc
Clementine Malibu Lake is an health care organization with primary practice located at 29470 Lake Vista Dr , Agoura Hills CA 91301-2818. The organization recently has only one registered license in Ambulatory Health Care Facilities / Adolescent and Children Mental Health, which is considered as the primary health care specialty. Monte Nido Lake Vista, Llc can be contacted via phone (747) 212-5021, or through Bagley, Mike via phone (305) 663-1876.

Contact Information

Primary practice address
29470 Lake Vista Dr Agoura Hills CA 91301-2818
Phone: (747) 212-5021
Fax: (818) 575-7327
Website:
Map and Directions
Authorized official contact:
Name: Bagley, Mike
Phone: (305) 663-1876

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Adolescent and Children Mental Health 261QM0855X

Profile Details

NPI number 1780105551
LBN Legal business name Monte Nido Lake Vista, Llc
DBA Doing business as Clementine Malibu Lake
Authorized official Bagley, Mike
Entity Organization
Organization subpart 1 Yes
Enumeration date Jul 3rd, 2017
Last updated May 27th, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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