Provider Demographics
NPI:1235871716
Name:MEDICHEX, INC
Entity Type:Organization
Organization Name:MEDICHEX, INC
Other - Org Name:LIFT OFF RECOVERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TRINAJOY
Authorized Official - Middle Name:
Authorized Official - Last Name:AGUILAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-381-0432
Mailing Address - Street 1:1563 W EMBASSY ST
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92802-1016
Mailing Address - Country:US
Mailing Address - Phone:714-844-2858
Mailing Address - Fax:714-276-9997
Practice Address - Street 1:1910 SANDALWOOD AVE
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835-2260
Practice Address - Country:US
Practice Address - Phone:714-844-2858
Practice Address - Fax:714-276-9997
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEDICHEX
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-04-13
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health