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NPI Code Detail

MEDICARE: AKUA BEHAVIORAL HEALTH, INC

MEDICARE: AKUA BEHAVIORAL HEALTH, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1324500000XSubstance Abuse Rehabilitation Facility

General Provider Information

NPI Number : 1447804612
Entity Type Code : Organization
Provider Name (Legal Business Name) : AKUA BEHAVIORAL HEALTH, INC
Provider Business Mailing Address
First Line : 20271 SW BIRCH ST STE 200
Second Line :
City : NEWPORT BEACH
State : CA
Zip : 92660-1752
Country : US
Telephone Number : 949-350-7125
Fax Number : 949-891-0366
Provider Business Practice Location Address
First Line : 2821 B ST
Second Line :
City : SAN DIEGO
State : CA
Zip : 92102-2208
Country : US
Telephone Number : 949-777-2283
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : STEPHEN MERCURIO
Credential :
Telephone Number : 949-777-2283
Provider Enumeration Date : 07/26/2019
Last Update Date : 07/26/2019

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Directions to “AKUA BEHAVIORAL HEALTH, INC ” Practice Location

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