Organization
PACIFIC BEACH HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS HATHORN (CEO)
(858) 717-4322
Entity
Organization
Contact information
Practice address
2108 GARNET AVE STE A, SAN DIEGO, CA 92109-3671
(858) 717-4322
Mailing address
2108 GARNET AVE STE A, SAN DIEGO, CA 92109-3671
(858) 717-4322
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
06/10/2021
Last updated
05/02/2024
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