Healthcare Provider Details

I. General information

NPI: 1508672577
Provider Name (Legal Business Name): AXIS MENTAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2024
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2010 MAIN STREET SUITE 250
IRVINE CA
92614
US

IV. Provider business mailing address

2010 MAIN STREET SUITE 250
IRVINE CA
92614
US

V. Phone/Fax

Practice location:
  • Phone: 949-685-0041
  • Fax: 949-200-4512
Mailing address:
  • Phone:
  • 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

VIII. Authorized Official

Name: MRS. CASEY POSTMA
Title or Position: COMPLIANCE DIRECTOR
Credential:
Phone: 562-739-0878