Healthcare Provider Details

I. General information

NPI: 1194309765
Provider Name (Legal Business Name): ACERA HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2021
Last Update Date: 08/20/2024
Certification Date: 08/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 BRISTOL ST STE 250
COSTA MESA CA
92626-7336
US

IV. Provider business mailing address

3843 S BRISTOL ST PMB #621
SANTA ANA CA
92704-7426
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State
# 3
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