Healthcare Provider Details

I. General information

NPI: 1982255477
Provider Name (Legal Business Name): MENTAL HEALTH SYSTEMS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2019
Last Update Date: 08/27/2020
Certification Date: 08/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13010 PASEO LUCIDO
SAN DIEGO CA
92128-4478
US

IV. Provider business mailing address

9465 FARNHAM ST
SAN DIEGO CA
92123-1308
US

V. Phone/Fax

Practice location:
  • Phone: 760-744-3672
  • Fax:
Mailing address:
  • Phone: 858-573-2600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/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