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Organization

MISSION PREP HEALTHCARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JEFFREY FARBMAN (DIRECTOR OF BILLING)
(949) 301-2863
Entity
Organization

Contact information

Practice address
28111 PALOS VERDES DR E, RANCHO PALOS VERDES, CA 90275-5120
(833) 589-5150
(949) 579-2876
Mailing address
30310 RANCHO VIEJO RD, SAN JUAN CAPISTRANO, CA 92675-1576
(949) 579-2876

Taxonomy

Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
191230AP
STATE OF CALIFORNIA DEPARTMENT OF HEALTH CARE SERVICES
CA
01
198209767
STATE OF CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
CA
01
578314
THE JOINT COMMISSION
CA
Enumeration date
07/20/2022
Last updated
07/11/2025
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