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General NPI Number Information
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NPI Number | 1700409356
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Entity Type | Organization
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Legal Business Name | EVER WELL HEALTH SYSTEMS, LLC
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Dates
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Enumeration Date | 05/18/2020
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Last Update Date | 10/15/2024
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Provider Practice Location Address
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Address Line | 1201 W SWAIN RD
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City | STOCKTON
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State | CA
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Zip | 95207-4228
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Country | US
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Telephone | 805-242-0135
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Fax |
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Provider Business Mailing Address
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Address Line | 310 JAMES WAY STE 250
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City | PISMO BEACH
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State | CA
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Zip | 93449-2877
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Country | US
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Telephone | 805-242-0135
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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 | DR. CHRISTOPHER LUIS ZUBIATE
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Credential | DHA, MSW
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Telephone | 805-242-0135
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3104A0625X
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Taxonomy Name | Assisted Living Facility (Mental Illness)
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License Number |
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License Number State |
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