MEDICARE: PH WELLNESS, INC.

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

General Provider Information

NPI Number	:	1881335438
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PH WELLNESS, INC.

Provider Business Mailing Address
First Line	:	12534 VALLEY VIEW ST # 169
Second Line	:
City	:	GARDEN GROVE
State	:	CA
Zip	:	92845-2006
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12882 VALLEY VIEW ST STE 8AND9
Second Line	:
City	:	GARDEN GROVE
State	:	CA
Zip	:	92845-2519
Country	:	US
Telephone Number	:	951-507-3145
Fax Number	:

Authorized Official
Title or Position	:	BILLING MANAGER
Name	:	ANTHONY FERRIGNO
Credential	:
Telephone Number	:	949-446-6280

Provider Enumeration Date	:	04/06/2022
Last Update Date	:	11/21/2025

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