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General NPI Number Information
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NPI Number | 1053135665
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Entity Type | Organization
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Legal Business Name | PH WELLNESS, INC.
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Dates
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Enumeration Date | 11/11/2024
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Last Update Date | 11/21/2025
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Provider Practice Location Address
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Address Line | 7770 BROADACRE PL
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City | RIVERSIDE
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State | CA
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Zip | 92504-5401
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Country | US
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Telephone | 951-335-5576
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Fax |
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Provider Business Mailing Address
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Address Line | 12534 VALLEY VIEW ST STE 169
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City | GARDEN GROVE
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State | CA
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Zip | 92845-2006
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | ANTHONY FERRIGNO
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Credential |
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Telephone | 949-446-6280
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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