Healthcare Provider Details

I. General information

NPI: 1548690035
Provider Name (Legal Business Name): BIENESTAR HUMAN SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2013
Last Update Date: 05/22/2025
Certification Date: 05/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5326 E BEVERLY BLVD
LOS ANGELES CA
90022-2104
US

IV. Provider business mailing address

5326 E BEVERLY BLVD
LOS ANGELES CA
90022-2104
US

V. Phone/Fax

Practice location:
  • Phone: 323-727-7896
  • Fax: 323-727-0284
Mailing address:
  • Phone: 323-545-6577
  • Fax: 323-476-0397

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. ROBERT CONTRERAS
Title or Position: CEO
Credential: MBA
Phone: 323-727-7896