MEDICARE: MENTAL HEALTH SYSTEMS, 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
1	251S00000X	Community/Behavioral Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457489478
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MENTAL HEALTH SYSTEMS, INC.

Provider Business Mailing Address
First Line	:	9465 FARNHAM ST
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92123-1308
Country	:	US
Telephone Number	:	858-573-2600
Fax Number	:

Provider Business Practice Location Address
First Line	:	1076 SANTO ANTONIO DR
Second Line	:	SUITE B & D, RMS. 2, 4, 9, & 12
City	:	COLTON
State	:	CA
Zip	:	92324-8103
Country	:	US
Telephone Number	:	909-357-4585
Fax Number	:	909-357-4589

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	JAMES C CALLAGHAN JR.
Credential	:
Telephone Number	:	858-573-2600

Provider Enumeration Date	:	03/01/2007
Last Update Date	:	08/26/2020

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