Healthcare Provider Details

I. General information

NPI: 1174442685
Provider Name (Legal Business Name): KAIZEN HEALTH INDIANA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5334 SAINT JOE RD
FORT WAYNE IN
46835-3324
US

IV. Provider business mailing address

2913 PULLMAN ST
SANTA ANA CA
92705-5818
US

V. Phone/Fax

Practice location:
  • Phone: 949-933-6412
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN BIEHL
Title or Position: CEO
Credential:
Phone: 949-933-6412