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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