| Behavioral Health Services, Inc. | |
|
15519 Crenshaw Blvd Gardena CA 90249-4525 | |
| (310) 679-9031 | |
| (310) 679-9034 |
| Full Name | Behavioral Health Services, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 15519 Crenshaw Blvd, Gardena, California |
| Authorized Official Name and Position | Theresa Lynn Cannon (CHIEF COMPLIANCE OFFICER) |
| Authorized Official Contact | 3106799126 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Behavioral Health Services, Inc. 15519 Crenshaw Blvd Gardena CA 90249-4525 Ph: (310) 679-9126 | Behavioral Health Services, Inc. 15519 Crenshaw Blvd Gardena CA 90249-4525 Ph: (310) 679-9031 |
| NPI Number | 1407984800 |
|---|---|
| Provider Enumeration Date | 02/28/2007 |
| Last Update Date | 06/07/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407984800 | NPI | - | NPPES |
| 190007HN | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 190007HN (California) | Primary |
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