Organization
BEHAVIORAL HEALTH SERVICES
Active
Other names
Patterns
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TERI CANNON (EXECUTIVE VICE PRESIDENT)
(310) 679-9126
Entity
Organization
Contact information
Practice address
12917 CERISE AVE, HAWTHORNE, CA 90250-5520
(310) 675-4431
(310) 675-4434
Mailing address
15519 CRENSHAW BLVD, GARDENA, CA 90249-4525
(310) 679-9126
(310) 679-2920
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
190007FN
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
190007FN
DRUG AND ALCOHOL LICENSE
CA
Enumeration date
03/07/2007
Last updated
08/22/2020
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