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General NPI Number Information
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NPI Number | 1366262883
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Entity Type | Organization
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Legal Business Name | PURE MENTAL HEALTH INC.
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Dates
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Enumeration Date | 10/10/2024
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Last Update Date | 10/10/2024
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Provider Practice Location Address
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Address Line | 10650 REAGAN ST UNIT 824
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City | LOS ALAMITOS
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State | CA
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Zip | 90720-8844
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Country | US
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Telephone | 310-447-3842
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Fax |
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Provider Business Mailing Address
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Address Line | 10650 REAGAN ST UNIT 824
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City | LOS ALAMITOS
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State | CA
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Zip | 90720-8844
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT, DIRECTOR
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Name | GINGER HULST
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Credential | DNP, NP-C
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Telephone | 310-447-3842
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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