Healthcare Provider Details

I. General information

NPI: 1558749937
Provider Name (Legal Business Name): HOAG NEUROBEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2015
Last Update Date: 06/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HOAG DR
NEWPORT BEACH CA
92663-4162
US

IV. Provider business mailing address

1 HOAG DR
NEWPORT BEACH CA
92663-4162
US

V. Phone/Fax

Practice location:
  • Phone: 949-764-5656
  • Fax:
Mailing address:
  • Phone: 949-764-8109
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. ANDREW GUARNI
Title or Position: SENIOR VP AND CFO
Credential:
Phone: 949-764-4448