Organization
MILESTONE DETOX, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SHAWN WHITT (CEO)
(949) 344-8149
Entity
Organization
Contact information
Practice address
31981 CALLE WINONA, SAN JUAN CAPISTRANO, CA 92675-3076
(949) 344-8149
Mailing address
1040 W 17TH ST, COSTA MESA, CA 92627-4503
(949) 388-4114
(949) 203-8540
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
01/03/2016
Last updated
01/18/2019
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