Experience Recovery Detox & Residential LLC.

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

EXPERIENCE RECOVERY DETOX & RESIDENTIAL LLC.

Practice address

3919 W Hazard Ave
Santa Ana, CA 92703-2625

Phone

(714) 713-5272

NPI assigned

Apr 26, 2017

Organization subpart

No

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

Authorized official

Name

Phu Nguyen

Title

Ceo

Phone

(714) 951-8514

Specialties & licenses 1

Addresses

Tax ID family

Experience Recovery Detox Residential LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Experience Recovery Detox & Residential LLC.

  • Substance Abuse Rehabilitation Facility
  • Santa Ana, CA
  • NPI 1316427446
  NPD tax ID

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

{
    "created_epoch": "1493164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752710400000",
    "number": "1194250258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3919 W HAZARD AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927032625",
            "telephone_number": "800-870-3973",
            "fax_number": "855-275-5428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3919 W HAZARD AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927032625",
            "telephone_number": "714-713-5272"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3921 W Hazard Ave",
            "address_purpose": "LOCATION",
            "city": "Santa Ana",
            "state": "CA",
            "postal_code": "927032625",
            "country_code": "US",
            "telephone_number": "714-951-8514",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EXPERIENCE RECOVERY DETOX & RESIDENTIAL LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-26",
        "last_updated": "2025-07-17",
        "certification_date": "2025-07-17",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "PHU",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "714-951-8514"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Everly
• Evernorth Direct Health LLC
• Lynette Dee Ewing, PSYCHIATRIC TECH.
• Tanji Ewing, MA, LMFT
• Executive Hand Therapy, Inc.
• Experience Recovery Detox & Residential LLC.
• Expresss Medz Inc
• Eyecare Specialists Medical Group, Inc.
• Eyeschoice Optometry
• Ez Meds, LLC

• Substance Abuse Rehabilitation Facility in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• Substance Abuse Rehabilitation Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2025; 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.