Organization
PSYCHOGENESIS DETOX CENTER
Active
Parent organization
INSPIRE HEALTH LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
INSPIRE HEALTH LLC
Authorized official
DR. NADER BABAI SIAHDOHONI PHD (CEO)
(949) 769-1372
Entity
Organization
Contact information
Practice address
3151 AIRWAY AVE STE C3, COSTA MESA, CA 92626-4622
(949) 769-1372
Mailing address
30912 STEEPLECHASE DR, SAN JUAN CAPISTRANO, CA 92675-1928
(949) 769-1372
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
02/20/2024
Last updated
02/20/2024
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