Provider Demographics
NPI:1639053689
Name:ENGAGE SELECT HEALTH & RECOVERY SOLUTIONS LLC
Entity type:Organization
Organization Name:ENGAGE SELECT HEALTH & RECOVERY SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHUTITA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEASON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:833-323-6424
Mailing Address - Street 1:42211 STONEWOOD RD APT 97
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591-3864
Mailing Address - Country:US
Mailing Address - Phone:586-690-1237
Mailing Address - Fax:
Practice Address - Street 1:1401 21ST ST # 6171
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95811-5226
Practice Address - Country:US
Practice Address - Phone:833-323-6424
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No405300000XOther Service ProvidersPrevention ProfessionalGroup - Multi-Specialty