MEDICARE: ALTIGNIS HEALTH LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center
2	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	656620	OTHER	CA	THE JOINT COMMISSION
2	300396AP	OTHER	CA	DEPARTMENT OF HEALTH CARE SERVICES

General Provider Information

NPI Number	:	1639791627
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALTIGNIS HEALTH LLC

Provider Business Mailing Address
First Line	:	34270 PACIFIC COAST HWY STE C
Second Line	:
City	:	DANA POINT
State	:	CA
Zip	:	92629-2847
Country	:	US
Telephone Number	:	949-877-2419
Fax Number	:	949-308-7789

Provider Business Practice Location Address
First Line	:	31642 COAST HWY STE 102
Second Line	:
City	:	LAGUNA BEACH
State	:	CA
Zip	:	92651-7017
Country	:	US
Telephone Number	:	310-402-4960
Fax Number	:	888-965-9813

Authorized Official
Title or Position	:	BILLING MANAGER
Name	:	MICHELLE L DUENSING
Credential	:
Telephone Number	:	949-877-2419

Provider Enumeration Date	:	05/12/2020
Last Update Date	:	08/22/2024

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Directions to “ALTIGNIS HEALTH LLC ” Practice Location

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