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NPI Code Detail

MEDICARE: DMS SERVICES, INC

MEDICARE: DMS 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
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1356981393
Entity Type Code : Organization
Provider Name (Legal Business Name) : DMS SERVICES, INC
Provider Business Mailing Address
First Line : 1633 E 4TH ST STE 160
Second Line :
City : SANTA ANA
State : CA
Zip : 92701-5176
Country : US
Telephone Number : 714-865-1769
Fax Number : 714-364-0071
Provider Business Practice Location Address
First Line : 601 S HARBOR BLVD
Second Line :
City : ANAHEIM
State : CA
Zip : 92805-4521
Country : US
Telephone Number : 714-908-0028
Fax Number :
Authorized Official
Title or Position : PROGRAM DIRECTOR
Name : LYNDA KOLYBA
Credential : LMFT
Telephone Number : 714-908-0028
Provider Enumeration Date : 01/07/2020
Last Update Date : 12/17/2024

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