Organization
RESURGENCE CALIFORNIA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TANISHA PORRECA (COO)
(828) 773-4477
Entity
Organization
Contact information
Practice address
3151 AIRWAY AVE STE K203, COSTA MESA, CA 92626-4638
(828) 773-4477
(888) 700-5053
Mailing address
3151 AIRWAY AVE STE K203, COSTA MESA, CA 92626-4638
(828) 773-4477
(888) 700-5053
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
CA
Other
Enumeration date
08/14/2018
Last updated
08/14/2018
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