Healthcare Provider Details
I. General information
NPI: 1245895192
Provider Name (Legal Business Name): HEALTHCARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/07/2019
Last Update Date: 11/19/2024
Certification Date: 11/19/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
320 N WILSHIRE AVE
ANAHEIM CA
92801-5825
US
IV. Provider business mailing address
151 KALMUS DR STE K1
COSTA MESA CA
92626-5975
US
V. Phone/Fax
- Phone: 714-780-1174
- Fax: 714-388-3697
- Phone: 714-384-3339
- Fax: 714-384-3879
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR0405X |
| Taxonomy | Substance Use Disorder Rehabilitation Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PETER
DAVIDSON
Title or Position: CEO
Credential:
Phone: 714-384-3339