Engrave Recovery Inc

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

ENGRAVE RECOVERY INC

Practice address

23072 Lake Center Dr Ste 203
Lake Forest, CA 92630-2864

Phone

(949) 775-3363

NPI assigned

Jul 14, 2026

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jackie Bahu

Title

Coo

Phone

(949) 899-7750

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1783987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786924800000",
    "number": "1063331882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23072 LAKE CENTER DR STE 203",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926302864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23072 LAKE CENTER DR STE 203",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926302864",
            "telephone_number": "949-775-3363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENGRAVE RECOVERY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-07-14",
        "last_updated": "2026-08-17",
        "certification_date": "2026-08-17",
        "status": "A",
        "authorized_official_last_name": "BAHU",
        "authorized_official_first_name": "JACKIE",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "949-899-7750"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Substance Use Disorder Rehabilitation Clinic/Center in Lake Forest, CA
• Providers in Lake Forest, CA by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.