Provider Demographics
NPI:1992402408
Name:BIENESTAR HUMAN SERVICES
Entity type:Organization
Organization Name:BIENESTAR HUMAN SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:CONTRERAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-545-6577
Mailing Address - Street 1:5326 E BEVERLY BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90022-2104
Mailing Address - Country:US
Mailing Address - Phone:323-545-6577
Mailing Address - Fax:
Practice Address - Street 1:180 E MISSION BLVD
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91766-1843
Practice Address - Country:US
Practice Address - Phone:909-397-7660
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BIENESTAR HUMAN SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-02-14
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health