Provider Demographics
NPI:1578370110
Name:AXIS MENTAL HEALTH LLC
Entity type:Organization
Organization Name:AXIS MENTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPLIANCE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CASEY
Authorized Official - Middle Name:
Authorized Official - Last Name:POSTMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-739-0878
Mailing Address - Street 1:620 NEWPORT CENTER DRIVE
Mailing Address - Street 2:SUITE 450
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:66563 5TH STREET
Practice Address - Street 2:UNIT A
Practice Address - City:DESERT HOT SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92240
Practice Address - Country:US
Practice Address - Phone:949-685-0041
Practice Address - Fax:949-200-4512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-17
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness