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SUMMIT COASTAL LIVING NPI 1831552850


NPI Information

NPI: 1831552850
Provider Name: SUMMIT COASTAL LIVING
Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization
Address:
165 E WILSON ST # B
COSTA MESA, CA
ZIP 92627
Phone: (949) 689-8880
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SUMMIT COASTAL LIVING is a substance abuse rehabilitation facility in Costa Mesa, CA. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. SUMMIT COASTAL LIVING NPI is 1831552850. The provider is registered as an organization entity type.

The provider's business location address is:

165 E WILSON ST # B
COSTA MESA, CA
ZIP 92627-564
Phone: (949) 689-8880

The provider's authorized official is Keith B Randle .
The authorized official title is President and has the following contact phone number (949) 689-8880.

The enumeration date for this NPI number is 3/29/2016 and was last updated on 3/29/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1324500000XSubstance Abuse Rehabilitation FacilityC50412CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1C50412OTHERCALIFORNIADR. KAMBIZ KARIMI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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