MEDICARE: AKUA BEHAVIORAL HEALTH, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
2	261QM0850X	Adult Mental Health Clinic/Center
3	323P00000X	Psychiatric Residential Treatment Facility
4	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1386205680
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AKUA BEHAVIORAL HEALTH, INC

Provider Business Mailing Address
First Line	:	20271 SW BIRCH ST STE 202
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-1752
Country	:	US
Telephone Number	:	949-777-2283
Fax Number	:

Provider Business Practice Location Address
First Line	:	10821 FAIR OAKS BLVD
Second Line	:
City	:	FAIR OAKS
State	:	CA
Zip	:	95628-7214
Country	:	US
Telephone Number	:	949-777-2283
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	STEPHEN MERCURIO
Credential	:
Telephone Number	:	949-777-2283

Provider Enumeration Date	:	06/26/2019
Last Update Date	:	05/07/2020

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