NPIMap

Organization Active NPI

Akua Behavioral Health, Inc

  • Substance Abuse Rehabilitation Facility
  • Costa Mesa, CA
National Provider Identifier
1154784445
Registry record updated Apr 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
300297EP Issued in CA
Legal business name
AKUA BEHAVIORAL HEALTH, INC
Practice address
725 W 20TH St
Costa Mesa, CA 92627-3486
Phone
(949) 777-2283
NPI assigned
Apr 4, 2016
Last updated
Apr 4, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2016

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

Authorized official

Name
Kenny Dewan
Title
Cfo
Phone
(949) 833-8101

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 300297EP CA Primary

Addresses

Primary practice location

725 W 20TH St
Costa Mesa, CA 92627-3486

Mailing address

20271 SW Birch St Ste 202
Newport Beach, CA 92660-1752
Phone (949) 777-2283

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

NPI Registry JSON

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

{
    "created_epoch": "1459728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459728000000",
    "number": "1154784445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20271 SW BIRCH ST STE 202",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926601752",
            "telephone_number": "949-777-2283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 W 20TH ST",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926273486",
            "telephone_number": "949-777-2283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AKUA BEHAVIORAL HEALTH, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-04",
        "last_updated": "2016-04-04",
        "status": "A",
        "authorized_official_last_name": "DEWAN",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "949-833-8101"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "300297EP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2016; 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.