Psychogenesis Detox Center

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

PSYCHOGENESIS DETOX CENTER

Practice address

3151 Airway Ave Ste C3
Costa Mesa, CA 92626-4622

Phone

(949) 769-1372

NPI assigned

Feb 20, 2024

Organization subpart

Yes

Parent organization

INSPIRE HEALTH LLCAs reported in NPPES

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

Authorized official

Name

Dr. Nader Babai Siahdohoni, PHDNPI 1477876753

Title

Ceo

Phone

(949) 769-1372

Specialties & licenses 4

Addresses

Part of

Inspire Health LLC

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Inspire Health LLC

  • Substance Abuse Rehabilitation Facility
  • Irvine, CA
  • NPI 1043750979
  NPPES parent name

Practitioners 1

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

• Nader Babai Siahdohoni, PHD

  • Clinical Psychologist
  • Costa Mesa, CA
  • NPI 1477876753
  NPD Authorized official

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

{
    "created_epoch": "1708387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708387200000",
    "number": "1467217372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30912 STEEPLECHASE DR",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926751928",
            "telephone_number": "949-769-1372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3151 AIRWAY AVE STE C3",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926264622",
            "telephone_number": "949-769-1372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOGENESIS DETOX CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INSPIRE HEALTH LLC",
        "enumeration_date": "2024-02-20",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A",
        "authorized_official_last_name": "BABAI SIAHDOHONI",
        "authorized_official_first_name": "NADER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "949-769-1372",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Substance Abuse Rehabilitation Facility in Costa Mesa, CA
• Providers in Costa Mesa, 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 Feb 20, 2024; 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.