Organization
BH-SD SOCIAL REHAB LM, LLC
Active
Other names
Jackson House
Organization subpart
No
Provider details
NPI number
Authorized official
CHAD ENGBRECHT ESQUIRE (CHIEF FINANCIAL OFFICER)
(619) 667-6009
Entity
Organization
Contact information
Practice address
5332 JACKSON DR, LA MESA, CA 91942-3040
(619) 667-6009
(619) 667-6118
Mailing address
7050 PARKWAY DR, LA MESA, CA 91942-1535
(619) 667-6009
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
323P00000X
Psychiatric Residential Treatment Facility
374603946
CA
Other
Enumeration date
07/12/2017
Last updated
01/11/2024
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