Healthcare Provider Details

I. General information

NPI: 1861562068
Provider Name (Legal Business Name): AMERICAN HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 04/01/2020
Certification Date: 04/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21505 NORWALK BLVD
HAWAIIAN GARDENS CA
90716-1121
US

IV. Provider business mailing address

PO BOX 801809
VALENCIA CA
91380-1809
US

V. Phone/Fax

Practice location:
  • Phone: 562-916-7581
  • Fax: 661-916-7592
Mailing address:
  • Phone: 661-254-6630
  • Fax: 661-254-6644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number19 145
License Number StateCA

VIII. Authorized Official

Name: PRAMESH P SHARMA
Title or Position: ADMINISTRATIVE DIRECTOR
Credential:
Phone: 661-254-6630