Healthcare Provider Details

I. General information

NPI: 1639791627
Provider Name (Legal Business Name): ALTIGNIS HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2020
Last Update Date: 08/22/2024
Certification Date: 08/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31642 COAST HWY STE 102
LAGUNA BEACH CA
92651-7017
US

IV. Provider business mailing address

34270 PACIFIC COAST HWY STE C
DANA POINT CA
92629-2847
US

V. Phone/Fax

Practice location:
  • Phone: 310-402-4960
  • Fax: 888-965-9813
Mailing address:
  • Phone: 949-877-2419
  • Fax: 949-308-7789

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE L DUENSING
Title or Position: BILLING MANAGER
Credential:
Phone: 949-877-2419