SOUTH COAST BEHAVIORAL HEALTH GUESTHOUSE INCORPORATION (NPI# 1669960803) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669960803 |
| Entity Type | Organization |
| Organization Name | SOUTH COAST BEHAVIORAL HEALTH GUESTHOUSE INCORPORATION |
| Other Organization Name | GEMINI HOUSE, LLC |
| Practice Address |
5302 Kenilworth Dr Huntington Beach CA 92649-4527 |
| Mailing Address |
3151 Airway Ave Ste T2 Costa Mesa CA 92626-4627 |
| Practice Telephone | 6573290700 |
| Enumeration Date | 2018-04-24 |
| Last Update Date | 2018-04-24 |
| Authorized Official Name | DR. LORNA PHAM (QUALITY ASSURANCE DIRECTOR) |
| Authorized Official Telephone | 9492370893 |
| Authorized Official Credential | PSYD |
| Is Organization Subpart | Y |
| Parent Organization Name | SOUTH COAST BEHAVIORAL HEALTH GUESTHOUSE INCORPORATED |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | 300313CP | CA | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Gemini House, LLC | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578051710 | South Coast Behavioral Health Guesthouse Incorporation | Substance Abuse Rehabilitation Facility | 275 E Wilson St, Costa Mesa, CA 92627-1574 | 2018-04-24 |
| 1760970909 | South Coast Behavioral Health Guesthouse Incorporation | Substance Abuse Rehabilitation Facility | 559 Pierpont Dr, Costa Mesa, CA 92626-3108 | 2018-04-24 |
| 1013405257 | South Coast Behavioral Health Guesthouse Incorporation | Substance Abuse Rehabilitation Facility | 1958 Balearic Dr, Costa Mesa, CA 92626-3513 | 2018-04-24 |
| 1679061816 | South Coast Behavioral Health Guesthouse Incorporation | Substance Abuse Rehabilitation Facility | 1068 San Pablo Cir, Costa Mesa, CA 92626-1614 | 2018-04-24 |
| 1093202434 | South Coast Behavioral Health Guesthouse Incorporation | Substance Abuse Rehabilitation Facility | 3151 Airway Ave Ste T2, Costa Mesa, CA 92626-4627 | 2018-04-20 |
| Street Address |
5302 KENILWORTH DR |
| City | HUNTINGTON BEACH |
| State | CA |
| Zip Code | 92649-4527 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225639305 | Tanisha Grant | Behavioral Analyst | 4592 Warner Ave, Huntington Beach, CA 92649 | 2020-11-04 |
| 1023582772 | Stanley Wayne Combs | Emergency Medicine | 16761 Edgewater Lane, Huntington Beach, CA 92649 | 2019-01-16 |
| 1609382084 | Loc Do | Pharmacist | 16922 Bolsa Chica, Huntington Beach, CA 92649 | 2017-12-20 |
| 1487166765 | Holly Forman | Marriage & Family Therapist | 17121 Tiffany Circle, Huntington Beach, CA 92649 | 2017-10-26 |
| 1205362522 | Pmh Laboratory Inc | Clinical Medical Laboratory | 5862 Edinger Ave, Huntington Beach, CA 92649 | 2017-05-05 |
| 1972050086 | Clear Reflections Psychol Assocs | Social Worker | 16897 Algonquin St., Ste L, Huntington Beach, CA 92649 | 2016-09-07 |
| 1588011274 | Wisdom Foods Inc | Dietitian, Registered | 16987 Algonquin Street Suite L, Huntington Beach, CA 92649 | 2016-05-23 |
| 1801253398 | Thierry Kolpin | Psychologist | 5202 Edinger, Huntington Beach, CA 92649 | 2016-01-28 |
| 1811374242 | Margarita Bernardo Velarde | Pediatrics | 17392 Wildrose Lane, Huntington Beach, CA 92649 | 2015-05-06 |
| 1023439809 | Orange County Labs Inc. | Clinical Medical Laboratory | 15165 Triton Ln, Huntington Beach, CA 92649 | 2013-12-23 |
| Find all providers in zip 92649 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932727914 | Double Helix Sober Living Solutions, Inc. | Substance Abuse Rehabilitation Facility | 8781 Albatross Dr, Huntington Beach, CA 92646-3302 | 2020-07-07 |
| 1730702838 | Smart-r Inc | Substance Abuse Rehabilitation Facility | 1355 Delaware St Apt 106, Huntington Beach, CA 92648-3734 | 2020-05-22 |
| 1154957967 | Beach House Retreat | Substance Abuse Rehabilitation Facility | 628 11th St, Huntington Beach, CA 92648-4032 | 2020-03-13 |
| 1467915462 | Hotel California By The Sea, LLC | Substance Abuse Rehabilitation Facility | 18801 Flagstaff Ln, Huntington Beach, CA 92646-1906 | 2019-04-08 |
| 1861955866 | Hotel California By The Sea, LLC | Substance Abuse Rehabilitation Facility | 19371 Worchester Ln, Huntington Beach, CA 92646-2045 | 2019-04-08 |
| 1851853956 | Hotel California By The Sea, LLC | Substance Abuse Rehabilitation Facility | 19671 Ditmar Ln, Huntington Beach, CA 92646-3111 | 2019-04-05 |
| 1497221394 | Axion Detox | Substance Abuse Rehabilitation Facility | 6272 Farinella Dr, Huntington Beach, CA 92647-4220 | 2018-10-17 |
| 1568946192 | Rise Again Recovery Inc. | Substance Abuse Rehabilitation Facility | 20681 Chaucer Ln, Huntington Beach, CA 92646-5809 | 2018-09-19 |
| 1326525361 | Gold Standard Recovery Services, LLC | Substance Abuse Rehabilitation Facility | 2319 Whitesands Dr Unit 3 & 4, Huntington Beach, CA 92648 | 2018-07-23 |
| 1437644457 | Beachview Treatment, LLC | Substance Abuse Rehabilitation Facility | 302 18th St, Huntington Beach, CA 92648-3802 | 2018-06-22 |
| Find all providers in HUNTINGTON BEACH | ||||
| City | HUNTINGTON BEACH |
| Zip Code | 92649 |
Please comment or provide details below to improve the information on SOUTH COAST BEHAVIORAL HEALTH GUESTHOUSE INCORPORATION.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.