NPIMap

Organization Active NPI

Akua Behavioral Health, Inc

  • Substance Abuse Rehabilitation Facility
  • Rancho Cordova, CA
National Provider Identifier
1114451663
Registry record updated Apr 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
340113AP Issued in CA
Legal business name
AKUA BEHAVIORAL HEALTH, INC
Practice address
10087 Terra Loma Dr
Rancho Cordova, CA 95670-3202
Phone
(949) 833-8101
NPI assigned
Apr 11, 2017
Last updated
Apr 11, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2017

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

Authorized official

Name
Mr. Kenny Dewan
Title
Ceo
Phone
(949) 833-8101

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 340113AP CA Primary

Addresses

Primary practice location

10087 Terra Loma Dr
Rancho Cordova, CA 95670-3202

Mailing address

20271 SW Birch St
Ste-200
Newport Beach, CA 92660-1752
Phone (949) 833-8101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

Other NPIs on the same Medicare enrollment 17

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 17

National Provider Directory

National Provider Directory
Tax ID family
Akua Behavioral Health Inc22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

Organizations that report the same tax identification number in the National Provider Directory.

View all 21

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1491868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491868800000",
    "number": "1114451663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20271 SW BIRCH ST",
            "address_2": "STE-200",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926601752",
            "telephone_number": "949-833-8101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10087 TERRA LOMA DR",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956703202",
            "telephone_number": "949-833-8101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AKUA BEHAVIORAL HEALTH, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-11",
        "last_updated": "2017-04-11",
        "status": "A",
        "authorized_official_last_name": "DEWAN",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "949-833-8101",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "340113AP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cordova, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.