PALM DETOX INC NPI 1558872614

NPI Information

  • NPI: 1558872614
  • Provider Name: PALM DETOX, INC
  • Classification: Substance Abuse Rehabilitation Facility - 324500000X
  • Entity Type: Organization
  • Doing Business As: PALM DETOX, INC
  • Address: 5455 CONNECTICUT AVE
    LA MESA, CA
    ZIP 91942
  • Phone: (855) 494-5796

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NPI Details

PALM DETOX, INC is a substance abuse rehabilitation facility in La 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. PALM DETOX, INC NPI is 1558872614. The provider is registered as an organization entity type.
The provider Is Doing Business As Palm Detox, Inc.

The provider's business location address is:

5455 CONNECTICUT AVE
LA MESA, CA
ZIP 91942-215
Phone: (855) 494-5796

The provider's authorized official is Robert Niznik .
The authorized official title is Ceo and has the following contact phone number (855) 494-5796.

The enumeration date for this NPI number is 10/17/2017 and was last updated on 5/29/2020.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1324500000XSubstance Abuse Rehabilitation FacilityCALIFORNIAYes

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: 11/21/2025

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