Provider Demographics
NPI:1114411360
Name:BEHAVIORAL HEALTH SOLUTIONS OF CALIFORNIA, LLC
Entity Type:Organization
Organization Name:BEHAVIORAL HEALTH SOLUTIONS OF CALIFORNIA, LLC
Other - Org Name:DESERT PALMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO AND AUTHORIZED OFFICIAL
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:DONAHUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-668-4232
Mailing Address - Street 1:19820 N 7TH ST STE 205
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85024-1694
Mailing Address - Country:US
Mailing Address - Phone:928-684-4039
Mailing Address - Fax:623-581-7624
Practice Address - Street 1:1309 S MARY AVE STE 100
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-3053
Practice Address - Country:US
Practice Address - Phone:602-740-8403
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-20
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA324500000X
324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility