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General NPI Number Information
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NPI Number | 1285542878
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Entity Type | Organization
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Legal Business Name | STILLWATER BEHAVIORAL HEALTH LLC
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Dates
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Enumeration Date | 09/01/2026
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Last Update Date | 09/01/2026
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Provider Practice Location Address
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Address Line | 657 W 19TH ST
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City | COSTA MESA
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State | CA
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Zip | 92627-8600
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Country | US
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Telephone | 949-233-3983
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Fax |
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Provider Business Mailing Address
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Address Line | 1901 NEWPORT BLVD STE 271
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City | COSTA MESA
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State | CA
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Zip | 92627-2286
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Country | US
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Telephone | 949-233-3983
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Fax |
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Authorized Official
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Title or Position | COO
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Name | MR. JOHN BENNETT
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Credential |
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Telephone | 949-233-3983
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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