Healthcare Provider Details

I. General information

NPI: 1568815454
Provider Name (Legal Business Name): NEW EXISTENCE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2016
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17971 EUCLID ST
FOUNTAIN VALLEY CA
92708-5409
US

IV. Provider business mailing address

PO BOX 2320
COSTA MESA CA
92628-2320
US

V. Phone/Fax

Practice location:
  • Phone: 949-919-6490
  • Fax: 714-333-4489
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number201605310246
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DYLAN WALKER
Title or Position: OWNER
Credential:
Phone: 253-653-2243