417 SAN CLEMENTE LLC NPI 1770968513

NPI Information

417 SAN CLEMENTE, LLC is a substance abuse treatment and children substance abuse rehabilitation facility in Mission Viejo, CA. The provider is a facility or distinct part of a facility for children that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of children with disorders in the use of drugs, alcohol, and other substances. Medical and supportive counseling services and education services are included. 417 SAN CLEMENTE, LLC NPI is 1770968513. The provider is registered as an organization entity type.

The provider's business location address is:

26010 ACERO STE 200
MISSION VIEJO, CA
ZIP 92691-716
Phone: (949) 525-7977

The provider's authorized official is Scott Christian Kalland .
The authorized official title is Owner/president and has the following contact phone number (949) 525-7977.

The enumeration date for this NPI number is 7/22/2015 and was last updated on 7/2/2019.

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:

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