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NPI Code Detail

MEDICARE: BEHAVIORAL HEALTH SERVICES INC.

MEDICARE: BEHAVIORAL HEALTH SERVICES INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency
2324500000XSubstance Abuse Rehabilitation Facility190007MNCA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1190007MNOTHERCAALCOHOL AND DRUG LICENSE

General Provider Information

NPI Number : 1932230505
Entity Type Code : Organization
Provider Name (Legal Business Name) : BEHAVIORAL HEALTH SERVICES INC.
Provider Business Mailing Address
First Line : 15519 CRENSHAW BLVD
Second Line :
City : GARDENA
State : CA
Zip : 90249-4525
Country : US
Telephone Number : 310-679-9126
Fax Number : 310-679-2920
Provider Business Practice Location Address
First Line : 2180 WEST VALLEY BLVD
Second Line :
City : POMONA
State : CA
Zip : 91768-3325
Country : US
Telephone Number : 909-865-2336
Fax Number : 909-865-1831
Authorized Official
Title or Position : CHIEF OPERATING OFFICER
Name : MICHAEL BALLUE
Credential : CADC-II, CHC
Telephone Number : 310-679-9126
Provider Enumeration Date : 03/08/2007
Last Update Date : 01/23/2026

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Directions to “BEHAVIORAL HEALTH SERVICES INC. ” Practice Location

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