Healthcare Provider Details

I. General information

NPI: 1295521060
Provider Name (Legal Business Name): WELLNESS RECOVERY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2025
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12061 BROWNING AVE
SANTA ANA CA
92705-3303
US

IV. Provider business mailing address

2915 RED HILL AVE STE A210C
COSTA MESA CA
92626-7979
US

V. Phone/Fax

Practice location:
  • Phone: 949-506-6162
  • Fax:
Mailing address:
  • Phone: 949-506-6162
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code310500000X
TaxonomyMental Illness Intermediate Care Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: EMILY HINSON
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 949-296-4135