PHOENIX HOUSE ORANGE COUNTY INC NPI 1972809341

NPI Information

  • NPI: 1972809341
  • Provider Name: PHOENIX HOUSE ORANGE COUNTY, INC
  • Classification: Substance Abuse Rehabilitation Facility - 3245S0500X
  • Specialization: Substance Abuse Treatment, Children
  • Entity Type: Organization
  • Other Name: CYS PHOENIX HOUSE WRAPAROUND
  • CLIA Number: 05D2275390
  • Address: 1207 E FRUIT ST
    SANTA ANA, CA
    ZIP 92701
  • Phone: (714) 953-9373

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NPI Details

PHOENIX HOUSE ORANGE COUNTY, INC is a substance abuse treatment and children substance abuse rehabilitation facility in Santa Ana, CA. The provider is a facility or distinct part of a facility for children that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of children with disorders in the use of drugs, alcohol, and other substances. Medical and supportive counseling services and education services are included. PHOENIX HOUSE ORANGE COUNTY, INC NPI is 1972809341. The provider is registered as an organization entity type.
The provider Other Name Is Cys Phoenix House Wraparound.

The provider's business location address is:

1207 E FRUIT ST
SANTA ANA, CA
ZIP 92701-206
Phone: (714) 953-9373

The provider's authorized official is Geoff Henderson .
The authorized official title is Senior Director and has the following contact phone number (714) 953-9373.

The CLIA number assigned to this NPI record is 05D2275390 - other - sud residential/outpatien with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/2/2011 and was last updated on 2/2/2011.

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
13245S0500XSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children261QM0855XCALIFORNIAYes

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This page was last updated on: 11/21/2025

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