Healthcare Provider Details

I. General information

NPI: 1144132366
Provider Name (Legal Business Name): GHC OF PHF GARDENS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

980 W 7TH ST BLDG B
SAN JACINTO CA
92582-3814
US

IV. Provider business mailing address

980 W 7TH ST BLDG B
SAN JACINTO CA
92582-3814
US

V. Phone/Fax

Practice location:
  • Phone: 951-654-9347
  • Fax:
Mailing address:
  • Phone: 951-654-9347
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: LOIS MASTROCOLA
Title or Position: CHIEF FINANCIAL
Credential:
Phone: 714-241-5600