Provider Demographics
NPI:1841699352
Name:COMMUNITY BEHAVIORAL HEALTH SOLUTIONS, INC
Entity type:Organization
Organization Name:COMMUNITY BEHAVIORAL HEALTH SOLUTIONS, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:
Authorized Official - Last Name:WYLIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-452-1200
Mailing Address - Street 1:4420 HOTEL CIRCLE CT STE 300
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-3424
Mailing Address - Country:US
Mailing Address - Phone:619-452-1200
Mailing Address - Fax:858-695-9734
Practice Address - Street 1:4420 HOTEL CIRCLE CT STE 300
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3424
Practice Address - Country:US
Practice Address - Phone:619-452-1200
Practice Address - Fax:858-695-9734
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-20
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA370140AP261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder