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General NPI Number Information
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NPI Number | 1245126044
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Entity Type | Organization
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Legal Business Name | FUTURES UNWALLED
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Dates
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Enumeration Date | 06/17/2025
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Last Update Date | 06/17/2025
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Provider Practice Location Address
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Address Line | 16161 PARKSIDE LN APT 88
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92647-3797
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Country | US
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Telephone | 714-253-4060
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Fax |
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Provider Business Mailing Address
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Address Line | 16787 BEACH BLVD # 1005
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92647-4848
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Country | US
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Telephone | 714-253-4060
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | ASHLEY NICOLE MEHR
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Credential |
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Telephone | 714-253-4060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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