Organization
RESURGENCE CALIFORNIA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAMILLE LINARES (VP OF COMPLIANCE)
(949) 933-2974
Entity
Organization
Contact information
Practice address
11851 WISTERIA AVE, FOUNTAIN VALLEY, CA 92708-2654
(888) 700-5053
Mailing address
3151 AIRWAY AVE STE E1, COSTA MESA, CA 92626-4620
(888) 700-5053
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
11/09/2022
Last updated
11/09/2022
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