Healthcare Provider Details

I. General information

NPI: 1578497285
Provider Name (Legal Business Name): BEHAVIORAL HEALTH PROGRAMS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3725 MAIN ST
MOSS POINT MS
39563-5107
US

IV. Provider business mailing address

PO BOX 9296
LAGUNA BEACH CA
92652-7261
US

V. Phone/Fax

Practice location:
  • Phone: 949-313-5245
  • Fax:
Mailing address:
  • Phone: 949-313-5238
  • Fax: 727-363-6994

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: JASON BIENEMAN
Title or Position: ADMINISTRATION
Credential:
Phone: 949-313-5238