12 SOUTH LLC is a substance abuse rehabilitation facility in Lake Forest, 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. 12 SOUTH LLC NPI is 1154789766. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is 12 South Recovery.
The provider's business location address is:
23712 BIRTCHER DRIVE
LAKE FOREST, CA
ZIP 92630
Phone: (888) 830-8374
Fax: (949) 215-6650
The provider's authorized official is Kyle Smith .
The authorized official title is Ceo/owner and has the following contact phone number (888) 830-8374.
The CLIA number assigned to this NPI record is 05D2150589 - other - outpatient treatment ctr with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 2/10/2016 and was last updated on 11/2/2022.