Healthcare Provider Details
I. General information
NPI: 1043949456
Provider Name (Legal Business Name): ACERA HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/09/2022
Last Update Date: 09/03/2024
Certification Date: 09/03/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2329 PURDUE DR
COSTA MESA CA
92626-6365
US
IV. Provider business mailing address
3843 S BRISTOL ST PMB #621
SANTA ANA CA
92704-7426
US
V. Phone/Fax
- Phone: 844-223-7212
- Fax:
- Phone: 949-518-0628
- Fax: 949-386-2212
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 320800000X |
| Taxonomy | Mental Illness Community Based Residential Treatment Facility |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 323P00000X |
| Taxonomy | Psychiatric Residential Treatment Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BRANDON
HILGER
Title or Position: CHIEF EXECUTIVE OFFICE
Credential:
Phone: 949-234-6250