Healthcare Provider Details

I. General information

NPI: 1982135307
Provider Name (Legal Business Name): BEHAVIORAL HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2017
Last Update Date: 03/30/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6838 W SUNSET BLVD
HOLLYWOOD CA
90028-7008
US

IV. Provider business mailing address

6838 W SUNSET BLVD
HOLLYWOOD CA
90028-7008
US

V. Phone/Fax

Practice location:
  • Phone: 323-461-5683
  • Fax:
Mailing address:
  • Phone: 323-461-3161
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: LORRAINE DILLARD
Title or Position: PROGRAM DIRECTOR
Credential: MSW
Phone: 323-461-3161