| Bhs-sud-av | |
|
5 Mareblu, Suites 100, 200, And 250 Aliso Viejo CA 92656-3014 | |
| (949) 643-6930 | |
| Not Available |
| Full Name | Bhs-sud-av |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 5 Mareblu, Suites 100, 200, And 250, Aliso Viejo, California |
| Authorized Official Name and Position | Chi Y Rajalingam (CHIEF COMPLIANCE OFFICER) |
| Authorized Official Contact | 7148343154 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bhs-sud-av 405 W 5th St Ste 212 Santa Ana CA 92701-4522 Ph: (714) 568-5614 | Bhs-sud-av 5 Mareblu, Suites 100, 200, And 250 Aliso Viejo CA 92656-3014 Ph: (949) 643-6930 |
| NPI Number | 1457574683 |
|---|---|
| Provider Enumeration Date | 04/10/2007 |
| Last Update Date | 12/20/2019 |
| Certification Date | 12/20/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457574683 | NPI | - | NPPES |
| 8090 | Medicaid | CA | |
| 308090 | Other | CA | ADP |
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