Healthcare Provider Details

I. General information

NPI: 1356090302
Provider Name (Legal Business Name): AHCS MENTAL HEALTH AND WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2022
Last Update Date: 12/05/2023
Certification Date: 12/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1377 N FAIR OAKS AVE
PASADENA CA
91103-2101
US

IV. Provider business mailing address

1377 N FAIR OAKS AVE
PASADENA CA
91103-2101
US

V. Phone/Fax

Practice location:
  • Phone: 626-794-1124
  • Fax: 626-797-0424
Mailing address:
  • Phone: 626-794-1124
  • Fax: 626-797-0424

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: RAJNIS JASANI
Title or Position: OWNER
Credential:
Phone: 626-794-1124