Provider Demographics
NPI:1124545470
Name:S.A.G.E. HOLISTIC HEALTH & WELLNESS CENTER
Entity Type:Organization
Organization Name:S.A.G.E. HOLISTIC HEALTH & WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:CELIS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LMFT
Authorized Official - Phone:714-391-3853
Mailing Address - Street 1:14081 YORBA ST STE 105
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-2050
Mailing Address - Country:US
Mailing Address - Phone:714-391-3853
Mailing Address - Fax:888-338-1074
Practice Address - Street 1:14081 YORBA ST STE 105
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-2050
Practice Address - Country:US
Practice Address - Phone:714-391-3853
Practice Address - Fax:888-338-1074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-28
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty