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General NPI Number Information
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NPI Number | 1831989029
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Entity Type | Organization
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Legal Business Name | ECHO RIDGE WELLNESS
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Dates
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Enumeration Date | 05/09/2025
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Last Update Date | 06/01/2025
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Provider Practice Location Address
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Address Line | 17141 MURPHY AVE STE 5C
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City | IRVINE
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State | CA
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Zip | 92614-5982
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Country | US
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Telephone | 951-473-6484
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 710308
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City | SANTEE
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State | CA
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Zip | 92072-0308
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Country | US
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Telephone | 951-473-6484
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. SEAN JEROME
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Credential | CADC II, QMHS
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Telephone | 951-473-6484
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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 | 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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