Organization
LUNA ROSE BEHAVIORAL HEALTH INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIM DOYLE (CEO)
(209) 607-3014
Entity
Organization
Contact information
Practice address
1901 NEWPORT BLVD STE 350, COSTA MESA, CA 92627-2299
(209) 607-3014
Mailing address
132 PLUM LILY, IRVINE, CA 92618-3519
(209) 607-3014
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
12/04/2020
Last updated
12/04/2020
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