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General NPI Number Information
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NPI Number | 1871617688
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Entity Type | Organization
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Legal Business Name | WELLSPACE HEALTH
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 07/10/2025
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Provider Practice Location Address
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Address Line | 1550 JULIESSE AVE
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City | SACRAMENTO
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State | CA
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Zip | 95817-3648
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Country | US
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Telephone | 916-737-5555
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Fax |
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Provider Business Mailing Address
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Address Line | 1500 EXPO PKWY
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City | SACRAMENTO
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State | CA
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Zip | 95815-4227
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Country | US
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Telephone | 916-550-5481
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Fax | 916-822-8974
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | DR. ALASDAIR JONATHAN PORTEUS
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Credential | PHD
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Telephone | 916-550-5444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 25950817
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License Number State | CA
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Taxonomy #2
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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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