Organization
SANCTUARY OF TRANSFORMATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DON BAUTISTA (OWNER)
(949) 439-3640
Entity
Organization
Contact information
Practice address
24381 SPARTAN ST, MISSION VIEJO, CA 92691
(949) 215-6602
Mailing address
29911 NIGUEL RD, STE 7723, LAGUNA NIGUEL, CA 92607
(949) 439-3640
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
300008AP
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300008AP
DHCS CERTIFICATION
CA
Enumeration date
01/16/2018
Last updated
01/26/2022
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