Healthcare Provider Details

I. General information

NPI: 1043067382
Provider Name (Legal Business Name): MONTEREY HEALTH SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2024
Last Update Date: 07/02/2024
Certification Date: 07/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10300 SADDLE RD
MONTEREY CA
93940-6671
US

IV. Provider business mailing address

4701 TELLER AVE STE 150D
NEWPORT BEACH CA
92660-8144
US

V. Phone/Fax

Practice location:
  • Phone: 949-466-0493
  • Fax:
Mailing address:
  • Phone: 949-466-0493
  • 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 Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: ERICK ROCCA
Title or Position: CFO
Credential:
Phone: 949-466-0493