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NPI Code Detail

MEDICARE: BEHAVIORAL HEALTH SERVICES INC.

MEDICARE: BEHAVIORAL HEALTH SERVICES INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1324500000XSubstance Abuse Rehabilitation Facility190007GNCA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1190007GNOTHERCADRUG AND ALCOHOL LICENSE

General Provider Information

NPI Number : 1245360130
Entity Type Code : Organization
Provider Name (Legal Business Name) : BEHAVIORAL HEALTH SERVICES INC.
Provider Business Mailing Address
First Line : 15519 CRENSHAW BLVD
Second Line :
City : GARDENA
State : CA
Zip : 90249-4525
Country : US
Telephone Number : 310-679-9126
Fax Number : 310-679-2920
Provider Business Practice Location Address
First Line : 2501 W EL SEGUNDO BLVD
Second Line :
City : HAWTHORNE
State : CA
Zip : 90250-3317
Country : US
Telephone Number : 323-754-2816
Fax Number : 323-754-2828
Authorized Official
Title or Position : EXECUTIVE VICE PRESIDENT
Name : MS. TERI CANNON
Credential :
Telephone Number : 310-679-9126
Provider Enumeration Date : 03/07/2007
Last Update Date : 08/22/2020

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Directions to “BEHAVIORAL HEALTH SERVICES INC. ” Practice Location

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