Provider Demographics
NPI:1235673005
Name:NULIFE MULHOLLAND LLC
Entity type:Organization
Organization Name:NULIFE MULHOLLAND LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:MEINTS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:818-274-6376
Mailing Address - Street 1:4232 LAS VIRGENES RD STE B
Mailing Address - Street 2:
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-3589
Mailing Address - Country:US
Mailing Address - Phone:888-508-1179
Mailing Address - Fax:
Practice Address - Street 1:4232 LAS VIRGENES RD STE B
Practice Address - Street 2:
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-3589
Practice Address - Country:US
Practice Address - Phone:888-508-1179
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE HARP LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-12-13
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA190805AP324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility