Healthcare Provider Details

I. General information

NPI: 1538806302
Provider Name (Legal Business Name): ACERA HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2022
Last Update Date: 08/21/2024
Certification Date: 08/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 DAHLIA AVE
CORONA DEL MAR CA
92625-2102
US

IV. Provider business mailing address

3151 AIRWAY AVE STE P3
COSTA MESA CA
92626-4626
US

V. Phone/Fax

Practice location:
  • Phone: 949-518-0628
  • Fax: 949-386-2212
Mailing address:
  • Phone: 949-228-4381
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: BRANDON HILGER
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 949-234-6250