Organization
CHANGING TIDES TREATMENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BERKELEY BEAUDEAN DAINS CATC, CIP,BS (CEO)
(805) 506-1541
Entity
Organization
Contact information
Practice address
2021 SPERRY AVE, SUITE 3, VENTURA, CA 93003-7408
(844) 883-3869
Mailing address
5301 SEABREEZE WAY, OXNARD, CA 93035-1048
(844) 883-3869
(805) 624-5311
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
01/23/2015
Last updated
01/23/2015
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