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SOCAL EMPOWERED, LLC
NPI 1528830619
Community Based Residential Treatment Facility, Mental Illness in Idaho Falls, ID

Active since October 23, 2023
5796 WILDROSE AVE, IDAHO FALLS, ID 83401(949) 701-3551(888) 846-8569 Get Directions Write a Review

NPPES record last updated: June 11, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 11, 2024, Oct 23, 2023 (2 updates tracked since 2023).

About Socal Empowered, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOCAL EMPOWERED, LLC (NPI 1528830619) is a healthcare organization registered as a community based residential treatment facility, mental illness in Idaho Falls, Idaho and active in the NPI registry since October 2023. The organization lists James Perraie, Managing Member, as its authorized official.

NPPES Registry Identity

NPI1528830619
Entity TypeOrganization
Primary Taxonomy320800000X
Legal Business NameSOCAL EMPOWERED, LLC
Location Address5796 WILDROSE AVEIdaho Falls, ID 83401-6597
Mailing Address22602 Costa Bella DrLake Forest, CA 92630-4218 · (949) 701-3551 · Fax (888) 846-8569
Phone(949) 701-3551
Fax(888) 846-8569
Organization SubpartNo
Authorized OfficialJames PerraieManaging Member · (949) 701-3551
Enumeration DateOctober 23, 2023
Last NPPES UpdateJune 11, 20242 updates tracked since enumeration
NPPES CertifiedJune 11, 2024
✔ NPI 1528830619 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity Based Residential Treatment Facility, Mental IllnessResidential Treatment Facilities
Taxonomy Code320800000X
Definition
A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
5796 WILDROSE AVE, Idaho Falls, ID 83401
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 13D2308258

Socal Enpowered LLC · Idaho Falls, ID
Expired · Jul 23, 2026
CLIA Number13D2308258
Laboratory TypeMental Health Residential
Certificate Effective DateJuly 24, 2024
Certificate Expiration DateJuly 23, 2026
Laboratory DirectorSanjai Thankachen
Laboratory Phone(888) 322-5929
Laboratory LocationSocal Enpowered LLC5796 Wildrose Ave, Idaho Falls, ID 83401
CLIA data matches this NPI record on: Address
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Socal Empowered, LLC's NPI number?

The NPI number for Socal Empowered, LLC is 1528830619. It was assigned to this organization in the NPPES registry on October 23, 2023.

Where is Socal Empowered, LLC located?

Socal Empowered, LLC is located at 5796 Wildrose Ave, Idaho Falls, ID 83401. The listed phone number is (949) 701-3551.

What is Socal Empowered, LLC's specialty?

The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Mental Illness with taxonomy code 320800000X.

When was this NPI record last updated?

The NPPES record for Socal Empowered, LLC was last updated on June 11, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.