Organization
CARESITE HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY GUSTAFSON (CHIEF EXECUTIVE OFFICER)
(855) 392-6411
Entity
Organization
Contact information
Practice address
28125 BRADLEY RD, SUITE 260B, MENIFEE, CA 92586-2248
(855) 392-6411
Mailing address
28125 BRADLEY RD, SUITE 260B, MENIFEE, CA 92586-2248
(855) 392-6411
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
—
—
261QR0208X
Mobile Radiology Clinic/Center
Primary
1578548822
CA
261QR1300X
Rural Health Clinic/Center
1578548822
CA
332U00000X
Home Delivered Meals
—
—
Other
Enumeration date
06/26/2015
Last updated
01/19/2016
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