Organization
PACIFIC SOLSTICE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRITTEN THERESE DEVEREUX LADAC (ADMINISTRATOR)
(949) 200-7929
Entity
Organization
Contact information
Practice address
26732 CROWN VALLEY PKWY STE 443, MISSION VIEJO, CA 92691-6375
(949) 402-9520
(949) 506-3716
Mailing address
26732 CROWN VALLEY PKWY STE 443, MISSION VIEJO, CA 92691-6375
(949) 402-9520
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
300636AP
CA
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
323P00000X
Psychiatric Residential Treatment Facility
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
306005875
DEPT OF SOCIAL SERVICES
CA
Enumeration date
02/23/2016
Last updated
03/27/2024
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