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General NPI Number Information
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NPI Number | 1245814292
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Entity Type | Organization
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Legal Business Name | BRICKFIRE LLC
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Dates
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Enumeration Date | 05/06/2021
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Last Update Date | 03/06/2024
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Provider Practice Location Address
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Address Line | 1560 BROOKHOLLOW DR STE 106
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City | SANTA ANA
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State | CA
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Zip | 92705-5428
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Country | US
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Telephone | 949-750-2720
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Fax | 714-699-9492
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Provider Business Mailing Address
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Address Line | 20500 BELSHAW AVE. DPT XLA 1126
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City | CARSON
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State | CA
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Zip | 90746-3506
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Country | US
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Telephone | 949-750-2720
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Fax |
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Authorized Official
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Title or Position | GENERAL COUNSEL
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Name | AARON BAILEY
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Credential |
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Telephone | 714-352-9138
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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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 | 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 #3
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/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 | 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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