Organization
MIRA COAST BEHAVIORAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. INDIGO ALLENDORF (DIRECTOR)
(949) 335-8802
Entity
Organization
Contact information
Practice address
326 OLD NEWPORT BLVD, NEWPORT BEACH, CA 92663-4121
(949) 335-8802
Mailing address
326 OLD NEWPORT BLVD, NEWPORT BEACH, CA 92663-4121
(754) 212-0473
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
09/14/2020
Last updated
09/27/2021
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