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Organization
RESURGENCE CALIFORNIA, LLC
Active
Organization
RESURGENCE CALIFORNIA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TANISHA PORRECA (COO)
(888) 700-5053
Entity
Organization
Contact information
Practice address
3129 PIERCE AVE, COSTA MESA, CA 92626-2827
(888) 700-5053
(949) 209-5490
Mailing address
3151 AIRWAY AVE STE E1, COSTA MESA, CA 92626-4620
(888) 700-5053
(949) 209-5490
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
—
NULL
Other
Enumeration date
07/17/2019
Last updated
07/17/2019
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