Provider Demographics
NPI:1609452838
Name:UNIVERSAL BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:UNIVERSAL BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PRIESING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:657-342-0265
Mailing Address - Street 1:2414 S FAIRVIEW ST STE 215
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-5318
Mailing Address - Country:US
Mailing Address - Phone:949-300-1657
Mailing Address - Fax:
Practice Address - Street 1:2414 S FAIRVIEW ST STE 215
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-5318
Practice Address - Country:US
Practice Address - Phone:949-300-1657
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-18
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care
No261QC1800XAmbulatory Health Care FacilitiesClinic/CenterCorporate Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No302R00000XManaged Care OrganizationsHealth Maintenance Organization
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility