| Phoenix House Orange County, Inc. | |
|
1207 E Fruit St Santa Ana CA 92701-4206 | |
| (714) 953-9373 | |
| (714) 953-7573 |
| Full Name | Phoenix House Orange County, Inc. |
|---|---|
| Speciality | Substance Abuse Rehabilitation Facility |
| Location | 1207 E Fruit St, Santa Ana, California |
| Authorized Official Name and Position | Shawna Renee Morris (SENIOR VICE PRESIDENT & EXECUTIVE D) |
| Authorized Official Contact | 8186863011 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Phoenix House Orange County, Inc. 11600 Eldridge Ave Lake View Terrace CA 91342-6506 Ph: (818) 686-3000 | Phoenix House Orange County, Inc. 1207 E Fruit St Santa Ana CA 92701-4206 Ph: (714) 953-9373 |
| NPI Number | 1295812626 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295812626 | NPI | - | NPPES |
| 300605606 | Other | CA | STATE LICENSE NUMBER- ADP |
| 1612 | Other | CA | CALIFORNIA |
| 8047 | Other | CA | DRUG MEDI-CAL PROVIDER NUMB |
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