Organization
CAPO COAST DETOX LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW LEE (ADMIN)
(619) 987-8078
Entity
Organization
Contact information
Practice address
34405 VIA GOMEZ, CAPISTRANO BEACH, CA 92624-1318
(949) 359-5669
Mailing address
21263 DOUBTFUL CANYON DR, CYPRESS, TX 77433-8470
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
12/05/2025
Last updated
01/12/2026
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