NPIMap

Organization Active NPI

Phoenix House Orange County, Inc

  • Children's Substance Abuse Rehabilitation Facility
  • Santa Ana, CA
National Provider Identifier
1972809341
Registry record updated Feb 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Children's Substance Abuse Rehabilitation FacilityTaxonomy code 3245S0500X
License
261QM0855X Issued in CA
Legal business name
PHOENIX HOUSE ORANGE COUNTY, INC
Practice address
1207 E Fruit St
Santa Ana, CA 92701-4206
Phone
(714) 953-9373
NPI assigned
Feb 2, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2011

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

Authorized official

Name
Mr. Geoff Henderson
Title
Senior Director
Phone
(714) 953-9373

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Children's Substance Abuse Rehabilitation Facility 3245S0500X 261QM0855X CA Primary

Addresses

Primary practice location

1207 E Fruit St
Santa Ana, CA 92701-4206

Mailing address

1207 E Fruit St
Santa Ana, CA 92701-4206
Phone (714) 953-9373

Other names 1

  • CYS Phoenix House Wraparound Other name

National Provider Directory

National Provider Directory
Tax ID family
Phoenix House Orange County Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

1207 E Fruit St
Santa Ana, CA 92701
Phone (714) 953-9373

NPI Registry JSON

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

{
    "created_epoch": "1296604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296604800000",
    "number": "1972809341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1207 E FRUIT ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927014206",
            "telephone_number": "714-953-9373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 E FRUIT ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927014206",
            "telephone_number": "714-953-9373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX HOUSE ORANGE COUNTY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-02",
        "last_updated": "2011-02-02",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "GEOFF",
        "authorized_official_title_or_position": "SENIOR DIRECTOR",
        "authorized_official_telephone_number": "714-953-9373",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": "CA",
            "license": "261QM0855X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CYS Phoenix House Wraparound",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2011; 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.