Organization
CAPO COAST RECOVERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATTHEW LEE (ADMIN)
(949) 359-5669
Entity
Organization
Contact information
Practice address
34405 VIA GOMEZ, CAPISTRANO BEACH, CA 92624-1318
(949) 359-5669
Mailing address
34249 CAMINO CAPISTRANO, CAPISTRANO BEACH, CA 92624-1156
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
02/20/2024
Last updated
02/20/2024
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