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General NPI Number Information
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NPI Number | 1205646882
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Entity Type | Organization
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Legal Business Name | BIENESTAR HUMAN SERVICES
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Dates
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Enumeration Date | 01/07/2025
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 436 W 4TH ST
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City | POMONA
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State | CA
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Zip | 91766-1622
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Country | US
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Telephone | 323-545-6577
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Fax |
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Provider Business Mailing Address
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Address Line | 5326 E BEVERLY BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90022-2104
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Country | US
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Telephone | 866-590-6411
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Fax |
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Authorized Official
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Title or Position | PRESIDENT & CEO
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Name | ROBERT CONTRERAS
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Credential | MBA
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Telephone | 323-545-6577
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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