| Wired Clean, Llc | |
|
1650 Adams Ave Costa Mesa CA 92626-4958 | |
| (949) 258-9219 | |
| Not Available |
| Full Name | Wired Clean, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1650 Adams Ave, Costa Mesa, California |
| Authorized Official Name and Position | Lee Heiligman (CEO) |
| Authorized Official Contact | 9492589219 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wired Clean, Llc 1650 Adams Ave Costa Mesa CA 92626-4958 Ph: (949) 258-9219 | Wired Clean, Llc 1650 Adams Ave Costa Mesa CA 92626-4958 Ph: (949) 258-9219 |
| NPI Number | 1568994515 |
|---|---|
| Provider Enumeration Date | 03/29/2017 |
| Last Update Date | 03/29/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568994515 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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