Organization
ENGRAVE RECOVERY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACKIE BAHU (COO)
(949) 899-7750
Entity
Organization
Contact information
Practice address
23072 LAKE CENTER DR STE 203, LAKE FOREST, CA 92630-2864
(949) 775-3363
Mailing address
23072 LAKE CENTER DR STE 203, LAKE FOREST, CA 92630-2864
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
07/14/2026
Last updated
08/17/2026
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