Organization
SHAHIDA K SYED ENTERPRISES LLC
Active
Parent organization
SHAHIDA K SYED ENTERPRISES LLC
Other names
SHAHIDA K SYED ENTERPRISES LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
SHAHIDA K SYED ENTERPRISES LLC
Authorized official
JAMIL SYED (CEO)
(951) 393-0191
Entity
Organization
Contact information
Practice address
4300 GREEN RIVER RD STE 108, CORONA, CA 92878-2306
(951) 393-0191
(951) 987-0042
Mailing address
19660 ARCADIA ST, CORONA, CA 92881-4302
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
330179EP
DEPARTMENT OF HEALTH CARE SERVICES
CA
Enumeration date
07/07/2023
Last updated
08/01/2024
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