| Luna Rose Behavioral Health Inc. | |
|
1901 Newport Blvd Ste 350 Costa Mesa CA 92627-2299 | |
| (209) 607-3014 | |
| Not Available |
| Full Name | Luna Rose Behavioral Health Inc. |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 1901 Newport Blvd Ste 350, Costa Mesa, California |
| Authorized Official Name and Position | Tim Doyle (CEO) |
| Authorized Official Contact | 2096073014 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Luna Rose Behavioral Health Inc. 132 Plum Lily Irvine CA 92618-3519 Ph: (209) 607-3014 | Luna Rose Behavioral Health Inc. 1901 Newport Blvd Ste 350 Costa Mesa CA 92627-2299 Ph: (209) 607-3014 |
| NPI Number | 1114523248 |
|---|---|
| Provider Enumeration Date | 12/04/2020 |
| Last Update Date | 12/04/2020 |
| Certification Date | 12/04/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114523248 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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