1831898881 NPI number — BEHAVIORAL HEALTH SERVICES, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831898881 NPI number — BEHAVIORAL HEALTH SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BEHAVIORAL HEALTH SERVICES, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1831898881
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/30/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
15519 CRENSHAW BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GARDENA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90249-4525
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
310-679-9126
Provider Business Mailing Address Fax Number:
310-679-7124

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12021 SOUTH WILMINGTON AVE.
Provider Second Line Business Practice Location Address:
BLDG. #18, SUITE 102
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90059-3046
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
424-454-6002
Provider Business Practice Location Address Fax Number:
5-583-3969
Provider Enumeration Date:
02/28/2023

Additional Information

Authorized Official

Authorized Official Last Name:
BALLUE
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF COMPLIANCE OFFICER
Authorized Official Telephone Number:
310-679-9126

Provider Taxonomy Codes

  • Taxonomy code: 261QR0405X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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