Healthcare Provider Details

I. General information

NPI: 1912352576
Provider Name (Legal Business Name): HEALTHCARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2016
Last Update Date: 11/19/2024
Certification Date: 11/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3880 ROSECRANS ST
SAN DIEGO CA
92110-3116
US

IV. Provider business mailing address

151 KALMUS DRIVE SUITE K-1
COSTA MESA CA
92626-5975
US

V. Phone/Fax

Practice location:
  • Phone: 619-515-0243
  • Fax: 619-235-0678
Mailing address:
  • Phone: 714-384-3216
  • Fax: 714-388-3802

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: PETER DAVIDSON
Title or Position: CEO
Credential:
Phone: 714-384-3339