Organization
DIVINE BLISS, INC.
Active
Other names
Costa Mesa Detox
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SERENA GUPTA PH.D., LMFT (PRESIDENT)
(714) 606-4012
Entity
Organization
Contact information
Practice address
1219 PARNELL PL, COSTA MESA, CA 92626-2737
(714) 581-3974
Mailing address
1219 PARNELL PL, COSTA MESA, CA 92626-2737
(954) 496-2885
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
10/04/2018
Last updated
12/09/2024
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