Healthcare Provider Details

I. General information

NPI: 1639053689
Provider Name (Legal Business Name): ENGAGE SELECT HEALTH & RECOVERY SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2025
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 21ST ST # 6171
SACRAMENTO CA
95811-5226
US

IV. Provider business mailing address

42211 STONEWOOD RD APT 97
TEMECULA CA
92591-3864
US

V. Phone/Fax

Practice location:
  • Phone: 833-323-6424
  • Fax:
Mailing address:
  • Phone: 586-690-1237
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code405300000X
TaxonomyPrevention Professional
License Number
License Number State

VIII. Authorized Official

Name: MS. SHUTITA DEASON
Title or Position: OWNER/MANAGER
Credential:
Phone: 833-323-6424