NPIMap

Organization Active NPI

Socal Empowered, LLC

  • Mental Illness Community Based Residential Treatment Facility
  • Idaho Falls, ID
National Provider Identifier
1528830619
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
SOCAL EMPOWERED, LLC
Practice address
5796 Wildrose Ave
Idaho Falls, ID 83401-6597
Phone
(949) 701-3551
Fax
(888) 846-8569
NPI assigned
Oct 23, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2024

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

Authorized official

Name
James Perraie
Title
Managing Member
Phone
(949) 701-3551

Specialties & licenses 1

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

Addresses

Primary practice location

5796 Wildrose Ave
Idaho Falls, ID 83401-6597

Mailing address

22602 Costa Bella Dr
Lake Forest, CA 92630-4218
Phone (949) 701-3551

National Provider Directory

National Provider Directory
Tax ID family
Socal Empowered LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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": "1698019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718064000000",
    "number": "1528830619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22602 COSTA BELLA DR",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926304218",
            "telephone_number": "949-701-3551",
            "fax_number": "888-846-8569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5796 WILDROSE AVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834016597",
            "telephone_number": "949-701-3551",
            "fax_number": "888-846-8569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOCAL EMPOWERED, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-23",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A",
        "authorized_official_last_name": "PERRAIE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "949-701-3551"
    },
    "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 Idaho Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.