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2414 S Fairview St Ste 215 Santa Ana CA 92704-5318 | |
| (657) 342-0265 | |
| (714) 398-8822 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Rehabilitation, Substance Use Disorder |
| Location | 2414 S Fairview St Ste 215, Santa Ana, California |
| Authorized Official Name and Position | Michael Richard Priesing (OWNER) |
| Authorized Official Contact | 6573420265 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2414 S Fairview St Ste 215 Santa Ana CA 92704-5318 Ph: (657) 342-0265 | 2414 S Fairview St Ste 215 Santa Ana CA 92704-5318 Ph: (657) 342-0265 |
| NPI Number | 1366985889 |
|---|---|
| Provider Enumeration Date | 12/01/2016 |
| Last Update Date | 05/20/2024 |
| Certification Date | 05/20/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366985889 | NPI | - | NPPES |
| 616832 | Other | CA | THE JOINT COMMISSION BEHAVIORAL HEALTH ACCREDIDATION PROGRAM |
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