Organization
BEACH HOUSE RETREAT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIAH ULLOA (OWNER)
(949) 629-8515
Entity
Organization
Contact information
Practice address
628 11TH ST, HUNTINGTON BEACH, CA 92648-4032
(949) 629-8515
(877) 963-6329
Mailing address
1049 IRVINE AVE, SUITE 877, NEWPORT BEACH, CA 92660
(949) 629-8515
(877) 963-6329
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300287AP
DHCS
CA
Enumeration date
03/13/2020
Last updated
03/13/2020
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