institution
Phoenix House Orange County, Inc.
Children's Substance Abuse Rehabilitation Facility in Santa Ana, California
NPI 1295812626

Phoenix House Orange County, Inc. is a Children's Substance Abuse Rehabilitation Facility based in Lake View Terrace, CA and is specialized in Substance Abuse Treatment, Children. Phoenix House Orange County, Inc. practices in Santa Ana, CA. The NPI Number for Phoenix House Orange County, Inc. is 1295812626 and holds a License No. 300605606 (California).

The current practice location address for Phoenix House Orange County, Inc. is 1207 E Fruit St, Santa Ana, CA and can be reached out via phone at 714-953-9373 and via fax at 714-953-7573. You can also correspond with Phoenix House Orange County, Inc. through the mailing address at 11600 ELDRIDGE AVE, LAKE VIEW TERRACE, CA - 91342-6506 (mailing address contact number: 818-686-3000).

Location: 1207 E Fruit St, Santa Ana, CA, 91342-6506
institution
Provider Profile Details
NPI Number
1295812626
Provider Name
Phoenix House Orange County, Inc.
Credential
Provider Entity Type
Organization
Address
1207 E Fruit St, Santa Ana, CA, 91342-6506
Phone Number
714-953-9373
Fax Number
714-953-7573
Provider Enumeration Date
11/01/2006
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
300605606 01 CA STATE LICENSE NUMBER- ADP
1612 01 CA CALIFORNIA
8047 01 CA DRUG MEDI-CAL PROVIDER NUMB
institution
Provider Business Practice Location Address Details
Address
1207 E Fruit St
City
State
Zip
92701-4206
Phone Number
714-953-9373
Fax Number
714-953-7573
person
Provider Business Mailing Address Details
Address
1207 E Fruit St
City
State
Zip
92701-4206
Phone Number
714-953-9373
Fax Number
714-953-7573
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
300033CN (California)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Residential Treatment Facilities
Classification
Substance Abuse Rehabilitation Facility
Speciality
-
Taxonomy
License No.
300033AN (California)
Definition
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.
person
Provider's Taxonomy Details 3
Type
Residential Treatment Facilities
Classification
Substance Abuse Rehabilitation Facility
Speciality
Substance Abuse Treatment, Children
Taxonomy
License No.
300605606 (California)
Definition
A facility or distinct part of a facility 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.
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