Organization
EVER WELL HEALTH SYSTEMS, LLC
Active
Other names
Delta at The Portside
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD STUART GROBERG (CFO)
(805) 070-0989
Entity
Organization
Contact information
Practice address
1950 E SONORA ST, STOCKTON, CA 95205-6364
(805) 242-0135
Mailing address
391 FRONT ST, SUITE E, GROVER BEACH, CA 93433-1553
(802) 242-0135
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
03/01/2017
Last updated
03/01/2017
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