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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› Verified 9 days ago
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