Healthcare Provider Details

I. General information

NPI: 1245126044
Provider Name (Legal Business Name): FUTURES UNWALLED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2025
Last Update Date: 06/17/2025
Certification Date: 05/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16161 PARKSIDE LN APT 88
HUNTINGTON BEACH CA
92647-3797
US

IV. Provider business mailing address

16787 BEACH BLVD # 1005
HUNTINGTON BEACH CA
92647-4848
US

V. Phone/Fax

Practice location:
  • Phone: 714-253-4060
  • Fax:
Mailing address:
  • Phone: 714-253-4060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: ASHLEY NICOLE MEHR
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 714-253-4060