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General NPI Number Information
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NPI Number | 1861912842
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Entity Type | Organization
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Legal Business Name | UMNPA, LLC
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Dates
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Enumeration Date | 06/21/2017
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Last Update Date | 06/21/2017
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Provider Practice Location Address
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Address Line | 10784 HARCOURT AVE
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City | ANAHEIM
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State | CA
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Zip | 92804-6341
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Country | US
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Telephone | 949-662-8787
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Fax |
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Provider Business Mailing Address
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Address Line | 21670 DUNROBIN WAY
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City | YORBA LINDA
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State | CA
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Zip | 92887-2647
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Country | US
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Telephone | 949-903-4834
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MR. TRAVIS RILEY
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Credential |
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Telephone | 949-903-4834
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 300670AP
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License Number State | CA
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