Healthcare Provider Details
I. General information
NPI: 1821126889
Provider Name (Legal Business Name): MENTAL HEALTH SYSTEMS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/01/2007
Last Update Date: 08/27/2020
Certification Date: 08/27/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
300 H ST
NEEDLES CA
92363-2928
US
IV. Provider business mailing address
9465 FARNHAM ST
SAN DIEGO CA
92123-1308
US
V. Phone/Fax
- Phone: 760-326-4590
- Fax: 760-326-3154
- Phone: 858-573-2600
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JAMES
C
CALLAGHAN
JR.
Title or Position: PRESIDENT/CEO
Credential:
Phone: 858-573-2600