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Organization

WEST COAST WELLNESS CENTERS LLC

Active
Parent organization
SOCAL ADDICTION & TREATMENT COMPANY, LLC
Other names
Wellness Counseling Vida Entera
Organization subpart
Yes

Provider details

NPI number
Legal business name
SOCAL ADDICTION & TREATMENT COMPANY, LLC
Authorized official
EDWARD ROUSSEAU (CHIEF ADMINISTRATIVE OFFICER)
(772) 266-7682
Entity
Organization

Contact information

Practice address
31631 AUTO CENTER DR, LAKE ELSINORE, CA 92530-4523
(623) 388-3353
Mailing address
31631 AUTO CENTER DR, LAKE ELSINORE, CA 92530-4523
(623) 388-3353

Taxonomy

Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
330133AP
CA
324500000X
Substance Abuse Rehabilitation Facility
330133BP
CA
324500000X
Substance Abuse Rehabilitation Facility
330133CP
CA
324500000X
Substance Abuse Rehabilitation Facility
330133DP
CA
324500000X
Substance Abuse Rehabilitation Facility
330133FP
CA
324500000X
Substance Abuse Rehabilitation Facility
330133GP
CA
324500000X
Substance Abuse Rehabilitation Facility
330133HP
CA

Other

Enumeration date
08/21/2015
Last updated
11/07/2018
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