Provider Demographics
NPI:1699487728
Name:TREASURE BEHAVIORAL HEALTH LLC
Entity type:Organization
Organization Name:TREASURE BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERTA
Authorized Official - Middle Name:E
Authorized Official - Last Name:IYAMU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-420-4362
Mailing Address - Street 1:710 GREG THATCH CIR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95835-2441
Mailing Address - Country:US
Mailing Address - Phone:916-420-4362
Mailing Address - Fax:
Practice Address - Street 1:710 GREG THATCH CIR
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95835-2441
Practice Address - Country:US
Practice Address - Phone:916-420-4362
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-20
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty