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Contact Information

PASSPORT TO ADAPTIVE LIVING
2291 PORTOLA ROAD
UNIT A
VENTURA, CA93003
 Phone: 805-339-0210
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Behavior Analyst

103K00000X
Indicates primary specialty

NPI Profile & details for PASSPORT TO ADAPTIVE LIVING

NPI # 1922452192
LBN Legal business name PASSPORT TO ADAPTIVE LIVING
Authorized official JEREMY WILSON - (CLINICAL DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 04/14/2016
Last updated 04/14/2016 - About 10 years ago
Identifiers
CA License # 0-16-7052
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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