Healthcare Provider Details

I. General information

NPI: 1053207753
Provider Name (Legal Business Name): PH WELLNESS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2025
Last Update Date: 11/21/2025
Certification Date: 11/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7927 WOODLAND DR
RIVERSIDE CA
92506-4806
US

IV. Provider business mailing address

12534 VALLEY VIEW ST # 169
GARDEN GROVE CA
92845-2006
US

V. Phone/Fax

Practice location:
  • Phone: 949-356-1944
  • Fax:
Mailing address:
  • Phone:
  • 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: ANTHONY FERRIGNO
Title or Position: BILLING MANAGER
Credential:
Phone: 949-446-6280