Immersive Wellness Centers, LLC
Immersive Wellness Centers, LLC is a healthcare organization registered as Substance Use Disorder Rehabilitation Clinic/Center in San Clemente, CA, holding Type 2 (organization) NPI 1104408780 since 2021. The authorized official on file is Angela Mcmahon, Coo.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1104408780 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Immersive Wellness Centers, LLC |
| Practice address | 120 CRISTIANITOS ROAD, UNIT 14207, San Clemente, CA, 92673 |
| Phone | 6198717345 |
| Enumeration date | 2021-04-23 |
| Last updated in NPPES | 2021-04-23 |
Authorized official
| Name | Angela Mcmahon |
|---|---|
| Title | Coo |
| Phone | 6198717345 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 261QR0405X | Substance Use Disorder Rehabilitation Clinic/Center | Primary | — | — |
Copy-ready billing details
Provider: Immersive Wellness Centers, LLC NPI: 1104408780 Taxonomy: 261QR0405X (Substance Use Disorder Rehabilitation Clinic/Center) Address: 120 CRISTIANITOS ROAD, UNIT 14207, San Clemente, CA, 92673
Verify this record
Cross-check NPI 1104408780 against the authoritative CMS record: view Immersive Wellness Centers, LLC on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
What is the NPI number for Immersive Wellness Centers, LLC?
Who is the authorized official for Immersive Wellness Centers, LLC?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2021-04-23.