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Organization
GUARDIAN HEALTH CARE SERVICES
Active
Organization
GUARDIAN HEALTH CARE SERVICES
Active
Other names
D'Amore Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN WOODFORD SMITH (CHIEF ADMINISTRATIVE OFFICER)
(949) 892-3020
Entity
Organization
Contact information
Practice address
3044 GRANT AVE, COSTA MESA, CA 92626-2855
(949) 402-9520
(714) 242-9700
Mailing address
3044 GRANT AVE, COSTA MESA, CA 92626-2855
(949) 402-9520
(714) 242-9700
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
MHBS160214
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
306005248
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
CA
01
—
MHBS160214
CALIFORNIA DEPARTMENT OF HEALTH CARE SERVICES
CA
Enumeration date
01/06/2017
Last updated
07/09/2021
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