Organization
IMS SERVICES LLC
Active
Other names
Harbor Detox
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW LEE (MANAGER)
(619) 987-8078
Entity
Organization
Contact information
Practice address
24832 LA PAZ AVE, A & B, DANA POINT, CA 92629-5398
(949) 359-5669
Mailing address
24832 LA PAZ AVE, SUITE A, DANA POINT, CA 92629-5398
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D2234068
CLIA
CA
01
—
300399AP
STATE OF CA DEPARTMENT OF HEALTH CARE SERVICES
CA
Enumeration date
06/16/2021
Last updated
06/26/2025
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