Provider Demographics
NPI:1902608466
Name:SACRAMENTO MENTAL HEALTH & WELLNESS LLC
Entity type:Organization
Organization Name:SACRAMENTO MENTAL HEALTH & WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:SOPHIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GOMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-306-5670
Mailing Address - Street 1:2915 RED HILL AVE STE A210C
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-7979
Mailing Address - Country:US
Mailing Address - Phone:201-306-5670
Mailing Address - Fax:
Practice Address - Street 1:1701 LA PLAYA WAY
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95864-1508
Practice Address - Country:US
Practice Address - Phone:201-306-5670
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-26
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility