Organization
JLK STRENGTH LLC
Active
Other names
405 Recovery
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS BEETS (DIRECTOR)
(949) 933-1931
Entity
Organization
Contact information
Practice address
3400 IRVINE AVE STE 220, NEWPORT BEACH, CA 92660-3103
(949) 531-1624
Mailing address
3400 IRVINE AVE STE 220, NEWPORT BEACH, CA 92660-3103
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300433AP
DHCS
CA
Enumeration date
05/03/2022
Last updated
05/03/2022
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