Organization
MIND OC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICTOR STANLEY JORDAN (CHIEF FINANCIAL OFFICER)
(508) 340-6228
Entity
Organization
Contact information
Practice address
18650 MACARTHUR BLVD STE 350, IRVINE, CA 92612-1205
(949) 400-4157
Mailing address
18650 MACARTHUR BLVD STE 350, IRVINE, CA 92612-1205
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Enumeration date
03/17/2022
Last updated
06/18/2024
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