Akua Behavioral Health, Inc
Organization Active NPI Substance Abuse Rehabilitation Facility · San Diego, CA
NPI 1255801767 · NPPES record last updated Nov 27, 2018
Key facts
- NPI
- 1255801767
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Substance Abuse Rehabilitation Facility 324500000X
- Legal business name
- AKUA BEHAVIORAL HEALTH, INC
- Practice address
- 3025 Reynard Way
San Diego, CA 92103-5434 - Phone
- (949) 777-2283
- NPI assigned
- Nov 27, 2018
- Organization subpart
- No
Authorized official
- Name
- Mr. Stephen Mercurio
- Title
- President
- Phone
- (949) 777-2283
Other NPIs on the same Medicare enrollment 17
Corporate family (same tax ID) 21
Practitioners 2
-
Trevor Olson, PSY.D.
-
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 | Yes |
Addresses
Primary practice location
3025 Reynard Way
San Diego, CA 92103-5434
Mailing address
20271 SW Birch St Ste 200
Newport Beach, CA 92660-1752
Other providers in San Diego, CA
- Kathryn Akong
- Kevan M. Akrami
- Sally Akrawe
- Evangeline Marie Akridge
- Natacha Akshoomoff
- Akua Behavioral Health, Inc
- Akua Behavioral Health, Inc
- Akua Behavioral Health, Inc
- Akua Behavioral Health, Inc
- Praveen Akuthota
All providers in San Diego, 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 Nov 27, 2018. 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.