Provider Demographics
NPI:1972632610
Name:ORANGE COUNTY ASSOCIATION FOR MENTAL HEALTH
Entity Type:Organization
Organization Name:ORANGE COUNTY ASSOCIATION FOR MENTAL HEALTH
Other - Org Name:AMHS MHA COSTA MESA RECOVERY CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:CHEIF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:A
Authorized Official - Last Name:THRASH
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:714-547-7559
Mailing Address - Street 1:1971 E 4TH ST STE 130A
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-3917
Mailing Address - Country:US
Mailing Address - Phone:714-547-7559
Mailing Address - Fax:714-640-5768
Practice Address - Street 1:3540 HOWARD WAY
Practice Address - Street 2:SUITE 150
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-1417
Practice Address - Country:US
Practice Address - Phone:949-646-9227
Practice Address - Fax:949-646-9191
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MENTAL HEALTH ASSOCIATION OF ORANGE COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-05
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW13874Medicare UPIN