Healthcare Provider Details

I. General information

NPI: 1790488112
Provider Name (Legal Business Name): HEALTHCARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2023
Last Update Date: 11/19/2024
Certification Date: 11/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 NORTH PEARL UNITS A, B, C, D
ANAHEIM CA
90801
US

IV. Provider business mailing address

151 KALMUS DR STE K1
COSTA MESA CA
92626-5975
US

V. Phone/Fax

Practice location:
  • Phone: 714-384-3339
  • Fax: 714-384-3879
Mailing address:
  • Phone: 714-384-3339
  • Fax: 714-384-3339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: PETER DAVIDSON
Title or Position: CEO
Credential:
Phone: 714-384-3339