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NPI Code Detail

MEDICARE: EVEXIA HEALTH SERVICES, LLC.

MEDICARE: EVEXIA HEALTH SERVICES, 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
1261QM2800XMethadone Clinic

General Provider Information

NPI Number : 1720545742
Entity Type Code : Organization
Provider Name (Legal Business Name) : EVEXIA HEALTH SERVICES, LLC.
Provider Business Mailing Address
First Line : 109 E 11TH ST
Second Line :
City : CORONA
State : CA
Zip : 92879-2157
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 109 E 11TH ST
Second Line :
City : CORONA
State : CA
Zip : 92879-2157
Country : US
Telephone Number : 951-391-1470
Fax Number :
Authorized Official
Title or Position : COO
Name : CHRISTOPHER LO
Credential :
Telephone Number : 951-391-1470
Provider Enumeration Date : 02/26/2019
Last Update Date : 06/08/2022

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Directions to “EVEXIA HEALTH SERVICES, LLC. ” Practice Location

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