Healthcare Provider Details
I. General information
NPI: 1346765351
Provider Name (Legal Business Name): WELLSPACE HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/10/2017
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4441 AUBURN BLVD STE E
SACRAMENTO CA
95841-4139
US
IV. Provider business mailing address
1500 EXPO PKWY
SACRAMENTO CA
95815-4227
US
V. Phone/Fax
- Phone: 916-473-5764
- Fax: 916-473-5766
- Phone: 916-550-5481
- Fax: 916-520-3921
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 324500000X |
| Taxonomy | Substance Abuse Rehabilitation Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ALASDAIR
JONATHAN
PORTEUS
Title or Position: CEO
Credential: PHD
Phone: 916-313-8413