SOCAL EMPOWERED LLC NPI 1851052062

NPI Information

NPI: 1851052062
Provider Name: SOCAL EMPOWERED, LLC
Classification: Community Based Residential Treatment Facility, Mental Illness - 320800000X
Entity Type: Organization

CLIA Number: 05D2269413

Address:
23671 BRASILIA ST
MISSION VIEJO, CA
ZIP 92691
Phone: (888) 846-8569
Get Directions

SOCAL EMPOWERED, LLC is a community based residential treatment facility mental illness in Mission Viejo, CA. The provider is a home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. SOCAL EMPOWERED, LLC NPI is 1851052062. The provider is registered as an organization entity type.

The provider's business location address is:

23671 BRASILIA ST
MISSION VIEJO, CA
ZIP 92691-047
Phone: (888) 846-8569

The provider's authorized official is James Perraie .
The authorized official title is Coo and has the following contact phone number (714) 313-3841.

The CLIA number assigned to this NPI record is 05D2269413 - other - social rehabilitation fac with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/10/2022 and was last updated on 1/10/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	320800000X	Community Based Residential Treatment Facility, Mental Illness				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	306006036	OTHER	CALIFORNIA	DEPARTMENT OF SOCIAL SERVICES

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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