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General NPI Number Information
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NPI Number | 1639053689
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Entity Type | Organization
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Legal Business Name | ENGAGE SELECT HEALTH & RECOVERY SOLUTIONS LLC
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Dates
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Enumeration Date | 08/04/2025
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 1401 21ST ST # 6171
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City | SACRAMENTO
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State | CA
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Zip | 95811-5226
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Country | US
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Telephone | 833-323-6424
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Fax |
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Provider Business Mailing Address
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Address Line | 42211 STONEWOOD RD APT 97
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City | TEMECULA
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State | CA
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Zip | 92591-3864
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Country | US
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Telephone | 586-690-1237
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | MS. SHUTITA DEASON
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Credential |
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Telephone | 833-323-6424
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 405300000X
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Taxonomy Name | Prevention Professional
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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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