Organization
SOCAL EMPOWERED, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES PERRAIE (COO)
(714) 313-3841
Entity
Organization
Contact information
Practice address
22602 COSTA BELLA DR, LAKE FOREST, CA 92630-4218
(888) 846-8569
Mailing address
22602 COSTA BELLA DR, LAKE FOREST, CA 92630-4218
(888) 846-8569
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
323P00000X
Psychiatric Residential Treatment Facility
Primary
—
—
Other
Enumeration date
06/07/2019
Last updated
01/10/2022
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