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General NPI Number Information
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NPI Number | 1962871848
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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 | 09/21/2015
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Last Update Date | 10/15/2024
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Provider Practice Location Address
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Address Line | 4951 E EIGHT MILE RD
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City | STOCKTON
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State | CA
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Zip | 95212-9449
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Country | US
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Telephone | 209-333-9731
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Fax | 209-333-9733
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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 | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number | 397005571
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License Number State | CA
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