| Lift Off | |
|
1567 W Embassy St Anaheim CA 92802-1016 | |
| (714) 844-2858 | |
| (714) 276-9997 |
| Full Name | Lift Off |
|---|---|
| Speciality | Clinic/center - Rehabilitation, Substance Use Disorder |
| Location | 1567 W Embassy St, Anaheim, California |
| Authorized Official Name and Position | Trinajoy Aguilar (DIRECTOR OF OPERATIONS) |
| Authorized Official Contact | 7143810432 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lift Off 1563 W Embassy St Anaheim CA 92802-1016 Ph: (714) 844-2858 | Lift Off 1567 W Embassy St Anaheim CA 92802-1016 Ph: (714) 844-2858 |
| NPI Number | 1447816509 |
|---|---|
| Provider Enumeration Date | 05/14/2019 |
| Last Update Date | 06/04/2024 |
| Certification Date | 06/04/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447816509 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| 261QR0405X | Clinic/center - Rehabilitation, Substance Use Disorder | (* (Not Available)) | Primary |
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