Organization
SOCAL EMPOWERED, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES PERRAIE (MANAGING MEMBER)
(949) 701-3551
Entity
Organization
Contact information
Practice address
5796 WILDROSE AVE, IDAHO FALLS, ID 83401-6597
(949) 701-3551
(888) 846-8569
Mailing address
22602 COSTA BELLA DR, LAKE FOREST, CA 92630-4218
(949) 701-3551
(888) 846-8569
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/23/2023
Last updated
06/11/2024
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