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General NPI Number Information
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NPI Number | 1366794547
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Entity Type | Organization
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Legal Business Name | HEARTHSTONE COMMUNITY SERVICES
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Dates
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Enumeration Date | 10/11/2012
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Last Update Date | 10/11/2012
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Provider Practice Location Address
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Address Line | 721 BRUNDAGE LN
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City | BAKERSFIELD
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State | CA
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Zip | 93304-3101
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Country | US
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Telephone | 661-861-0051
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Fax | 661-861-0053
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Provider Business Mailing Address
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Address Line | 721 BRUNDAGE LN
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City | BAKERSFIELD
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State | CA
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Zip | 93304-3101
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Country | US
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Telephone | 661-861-0051
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Fax | 661-861-0053
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. JAMES CHARLES DAMATO
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Credential |
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Telephone | 661-331-2075
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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