Akua Behavioral Health, Inc
Organization Active NPI Substance Abuse Rehabilitation Facility · Costa Mesa, CA
NPI 1104287671 · NPPES record last updated Mar 11, 2016
Key facts
- NPI
- 1104287671
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Substance Abuse Rehabilitation Facility 324500000X
- License
- 300297CP (CA)
- Legal business name
- AKUA BEHAVIORAL HEALTH, INC
- Practice address
- 369 Ralcam PL
Costa Mesa, CA 92627-1909 - Phone
- (949) 777-2283
- NPI assigned
- Mar 11, 2016
- Organization subpart
- No
Authorized official
- Name
- Kenny Dewan
- Title
- Cfo
- Phone
- (949) 833-8101
Other NPIs on the same Medicare enrollment 17
Corporate family (same tax ID) 21
Practitioners 1
-
Venice Lopez Sanchez, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210408000452 | CA | Part B Supplier - Clinic/Group Practice | 6002223179 |
Receives reassigned benefits from 1 practitioner 17 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Sacramento, CA; San Diego, CA; Rancho Cordova, CA; Newport Beach, CA; Long Beach, CA; Fair Oaks, CA; Costa Mesa, CA |
National Provider Directory
- Tax ID family
- Akua Behavioral Health Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Substance Abuse Rehabilitation Facility | 324500000X | 300297CP | CA | Yes |
Addresses
Primary practice location
369 Ralcam PL
Costa Mesa, CA 92627-1909
Mailing address
20271 SW Birch St Ste 202
Newport Beach, CA 92660-1752
Phone (949) 777-2283
Other providers in Costa Mesa, CA
- Meraj S Ahmed
- Nazli Ahmed
- Faith Modjeska Akers
- Adnan Akhtar
- Akua Behavioral Health, Inc
- Akua Behavioral Health, Inc
- Akua Behavioral Health, Inc
- Akua Behavioral Health, Inc
- Akua Behavioral Health, Inc
- Akua Behavioral Health, Inc
All providers in Costa Mesa, CA · Substance Abuse Rehabilitation Facility in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 11, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.