Organization
PHOENIX HOUSE ORANGE COUNTY, INC
Active
Other names
CYS Phoenix Wraparound
Organization subpart
No
Provider details
NPI number
Authorized official
MR. POURIA ABBASSI (SEN. VICE PRESIDENT)
(818) 686-3000
Entity
Organization
Contact information
Practice address
1615 E. 17TH ST, SUITE #100, SANTA ANA, CA 92705
(714) 955-4042
(714) 541-7924
Mailing address
1615 E. 17TH ST, SUITE #100, SANTA ANA, CA 92705
(714) 955-4042
(714) 541-7924
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
12/22/2010
Last updated
03/20/2013
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