05D2076644 CLIA NUMBER - HANBLECEYA TREATMENT CENTER INC

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Laboratory Demographics

CLIA Number: 05D2076644

Facility Name: HANBLECEYA TREATMENT CENTER INC

Facility Address:
5520 WELLESLEY STREET, STE 100
LA MESA, CA
ZIP 91942
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Facility Phone Number: 619 466-0547

Facility Type: Other - BEHAVIORAL HEALTH FACILIT

Certificate Type: Waiver

NPI Number: 1114333960

Taxonomy: 320600000X - Residential Treatment Facility, Intellectual and/or Developmental Disabilities
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.

CLIA Record

Field Name	Field Value
CLIA Number	05D2076644
LAB Type	Other - BEHAVIORAL HEALTH FACILIT
Facility Name	HANBLECEYA TREATMENT CENTER INC
Street	5520 WELLESLEY STREET, STE 100
City	LA MESA
State	CA
ZIP	91942
Phone	619 466-0547
CertificateType	4
CertificateEffectiveDate	4/23/2024
CertificateExpirationDate	4/22/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024