Healthcare Provider Details

I. General information

NPI: 1780253385
Provider Name (Legal Business Name): CARLSBAD MENTAL HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2021
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2850 PIO PICO DR STE A
CARLSBAD CA
92008-1555
US

IV. Provider business mailing address

34249 CAMINO CAPISTRANO # 101
CAPISTRANO BEACH CA
92624-1156
US

V. Phone/Fax

Practice location:
  • Phone: 949-359-5669
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW LEE
Title or Position: MANAGER
Credential:
Phone: 619-987-8078