Organization
PAT MOORE DETOX, LLC
Active
Parent organization
SPROUT HEALTH, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
SPROUT HEALTH, LLC
Authorized official
AREL MEISTER-ALDAMA (OWNER)
(914) 960-0080
Entity
Organization
Contact information
Practice address
536 HAMILTON ST, UNITS A, B AND C, COSTA MESA, CA 92627-2617
(949) 646-2830
(949) 646-3028
Mailing address
536 HAMILTON ST, UNITS A, B AND C, COSTA MESA, CA 92627-2617
(949) 646-2830
(949) 646-3028
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
300274AP
CA
Other
Enumeration date
03/20/2014
Last updated
03/20/2014
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