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General NPI Number Information
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NPI Number | 1639073109
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Entity Type | Organization
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Legal Business Name | OPULISE LLC
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Dates
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Enumeration Date | 10/07/2026
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Last Update Date | 10/07/2026
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Provider Practice Location Address
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Address Line | 9431 HAVEN AVE STE 100-1049
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-5878
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Country | US
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Telephone | 442-473-9345
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Fax |
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Provider Business Mailing Address
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Address Line | 9431 HAVEN AVE SUITE 100 PMB 1049
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730
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Country | US
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Telephone | 442-473-9345
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | RENITA LOIS ADIRA
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Credential | SUDRC III
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Telephone | 442-473-9345
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | NULL
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