Organization
SOCAL DETOX, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSHUA LAWRENCE BEAUCHAINE LMFT 47103 (PRESIDENT)
(949) 584-5957
Entity
Organization
Contact information
Practice address
1703 AVENIDA SALVADOR, SAN CLEMENTE, CA 92672-3268
(949) 584-5957
(360) 323-7285
Mailing address
1703 AVENIDA SALVADOR, SAN CLEMENTE, CA 92672-3268
(949) 584-5957
(360) 323-7285
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
TBD
CA
Other
Enumeration date
04/15/2014
Last updated
04/15/2014
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