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SOUTH SHORES DETOX LLC NPI 1932654241


NPI Information

NPI: 1932654241
Provider Name: SOUTH SHORES DETOX LLC

Doing Business As: ANCHORED RECOVERY COMMUNITY

Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization

CLIA Number: 05D2289389

Address:
32242 PASEO ADELANTO
SUITE D4
SAN JUAN CAPISTRANO, CA
ZIP 92675
Phone: (949) 289-2138
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SOUTH SHORES DETOX LLC is a substance abuse rehabilitation facility in San Juan Capistrano, 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. SOUTH SHORES DETOX LLC NPI is 1932654241. The provider is registered as an organization entity type.
The provider Is Doing Business As Anchored Recovery Community.

The provider's business location address is:

32242 PASEO ADELANTO
SUITE D4
SAN JUAN CAPISTRANO, CA
ZIP 92675-610
Phone: (949) 289-2138

The provider's authorized official is Josh Smith .
The authorized official title is Ceo and has the following contact phone number (949) 289-2138.

The CLIA number assigned to this NPI record is 05D2289389 - comp. outpatient rehab facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/17/2016 and was last updated on 8/17/2016.


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 FacilityYes

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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