Organization Active NPI

Odyssey Behavioral Health Centers LLC

  • Substance Abuse Rehabilitation Facility
  • Tustin, CA
National Provider Identifier
1205784170
Registry record updated Aug 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
ODYSSEY BEHAVIORAL HEALTH CENTERS LLC
Practice address
17821 17TH St Ste 275
Tustin, CA 92780-2161
Phone
(840) 228-7740
NPI assigned
Mar 17, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2026

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

Authorized official

Name
Jacob Daniel McCollum
Title
Ceo
Phone
(840) 228-7740

Specialties & licenses 1

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

Addresses

Primary practice location

17821 17TH St Ste 275
Tustin, CA 92780-2161

Mailing address

16593 China Berry CT
Chino Hills, CA 91709-6390
Phone (840) 228-7740

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1773705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787616000000",
    "number": "1205784170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16593 CHINA BERRY CT",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917096390",
            "telephone_number": "840-228-7740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17821 17TH ST STE 275",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927802161",
            "telephone_number": "840-228-7740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ODYSSEY BEHAVIORAL HEALTH CENTERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-17",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A",
        "authorized_official_last_name": "MCCOLLUM",
        "authorized_official_first_name": "JACOB",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "840-228-7740"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 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.