| Behavioral Health Services, Inc. | |
|
12954 Hawthorne Blvd Ste 100 Hawthorne CA 90250-4418 | |
| (310) 978-6900 | |
| (310) 218-5484 |
| Full Name | Behavioral Health Services, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 12954 Hawthorne Blvd Ste 100, Hawthorne, California |
| Authorized Official Name and Position | Shirley Summers (PRESIDENT/CEO) |
| Authorized Official Contact | 3106799126 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Behavioral Health Services, Inc. 15519 Crenshaw Blvd Gardena CA 90249-4525 Ph: (310) 679-9126 | Behavioral Health Services, Inc. 12954 Hawthorne Blvd Ste 100 Hawthorne CA 90250-4418 Ph: (310) 978-6900 |
| NPI Number | 1013528108 |
|---|---|
| Provider Enumeration Date | 08/12/2020 |
| Last Update Date | 08/12/2020 |
| Medicare PECOS PAC ID | 8729142146 |
|---|---|
| Medicare Enrollment ID | O20220727003278 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013528108 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Keith Ebilane, M.d., Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 13429 Hawthorne Blvd, Hawthorne, CA 90250 Phone: 310-644-8683 Fax: 310-644-0132 | |
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