Behavioral Health Services, Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

190007HN Issued in CA

Legal business name

BEHAVIORAL HEALTH SERVICES, INC.

Doing business as

South Bay Family Recovery Center

Practice address

15519 Crenshaw Blvd
Gardena, CA 90249-4525

Phone

(310) 679-9031

Fax

(310) 679-9034

NPI assigned

Feb 28, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Theresa Lynn Cannon

Title

Chief Compliance Officer

Phone

(310) 679-9126

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• South Bay Family Recovery Center Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275868800000",
    "number": "1407984800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15519 CRENSHAW BLVD",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902494525",
            "telephone_number": "310-679-9126",
            "fax_number": "310-679-2920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15519 CRENSHAW BLVD",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902494525",
            "telephone_number": "310-679-9031",
            "fax_number": "310-679-9034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEHAVIORAL HEALTH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2010-06-07",
        "status": "A",
        "authorized_official_last_name": "CANNON",
        "authorized_official_first_name": "THERESA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "CHIEF COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "310-679-9126",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "190007HN",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "190007HN",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Bay Family Recovery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Behavioral Health Services
• Behavioral Health Services
• Behavioral Health Services
• Behavioral Health Services
• Behavioral Health Services South Bay Family Recovery Center
• Melissa Bejarano
• Kimberly Bell
• Megan Bell
• Roxanne Bell
• Cheyla Bellamy, MA

• Community/Behavioral Health Agency in Gardena, CA
• Providers in Gardena, CA by specialty
• Community/Behavioral Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.