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401 W Civic Center Dr Suite 100, 500, 700 Santa Ana CA 92701-4515 | |
| (714) 480-6660 | |
| (714) 568-4933 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Rehabilitation, Substance Use Disorder |
| Location | 401 W Civic Center Dr, Santa Ana, California |
| Authorized Official Name and Position | Chi Y Rajalingam (CHIEF COMPLIANCE OFFICER) |
| Authorized Official Contact | 7148343154 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
405 W 5th St Ste 212 Santa Ana CA 92701-4522 Ph: (714) 568-5614 | 401 W Civic Center Dr Suite 100, 500, 700 Santa Ana CA 92701-4515 Ph: (714) 480-6660 |
| NPI Number | 1518080217 |
|---|---|
| Provider Enumeration Date | 04/09/2007 |
| Last Update Date | 02/24/2022 |
| Certification Date | 02/24/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518080217 | NPI | - | NPPES |
| 303025 | Other | CA | DRUG MEDI-CAL |
| 3025 | Medicaid | CA |
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