NPIMap

Organization Active NPI

Resurgence California

  • Mental Illness Community Based Residential Treatment Facility
  • Costa Mesa, CA
National Provider Identifier
1467060731
Registry record updated Nov 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
RESURGENCE CALIFORNIA
Practice address
3072 Madison Ave
Costa Mesa, CA 92626-2824
Phone
(619) 248-7806
Fax
(949) 209-5490
NPI assigned
Jul 22, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2022

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

Authorized official

Name
Camille Linares
Title
VP of Compliance
Phone
(888) 700-5053

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X Primary

Addresses

Primary practice location

3072 Madison Ave
Costa Mesa, CA 92626-2824

Mailing address

3151 Airway Ave Ste E1
Costa Mesa, CA 92626-4620
Phone (888) 700-5053

National Provider Directory

National Provider Directory
Tax ID family
Resurgence California LLC9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

NPI Registry JSON

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

{
    "created_epoch": "1595376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667952000000",
    "number": "1467060731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3151 AIRWAY AVE STE E1",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926264620",
            "telephone_number": "888-700-5053",
            "fax_number": "949-209-5490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3072 MADISON AVE",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926262824",
            "telephone_number": "619-248-7806",
            "fax_number": "949-209-5490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESURGENCE CALIFORNIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-22",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-09",
        "status": "A",
        "authorized_official_last_name": "LINARES",
        "authorized_official_first_name": "CAMILLE",
        "authorized_official_title_or_position": "VP OF COMPLIANCE",
        "authorized_official_telephone_number": "888-700-5053"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "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 Nov 9, 2022; 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.