Healthcare Provider Details

I. General information

NPI: 1114333960
Provider Name (Legal Business Name): HANBLECEYA TREATMENT CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2014
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5520 WELLESLEY ST STE 100
LA MESA CA
91942
US

IV. Provider business mailing address

7918 EL CAJON BLVD, STE N227
LA MESA CA
91942
US

V. Phone/Fax

Practice location:
  • Phone: 619-466-0547
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number374603028
License Number StateCA

VIII. Authorized Official

Name: AIMEE BOND
Title or Position: VP REVENUE CYCLE
Credential:
Phone: 615-751-7933