Organization
SOUTH SHORES DETOX LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSH D SMITH (CEO/OWNER)
(949) 289-2138
Entity
Organization
Contact information
Practice address
32851 BUCCANEER ST, DANA POINT, CA 92629-1312
(949) 289-2138
Mailing address
31746 VIA BELARDES, SAN JUAN CAPISTRANO, CA 92675-3031
(949) 289-2138
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
300324AP
CA
324500000X
Substance Abuse Rehabilitation Facility
Primary
300352AP
CA
Other
Enumeration date
12/23/2015
Last updated
09/09/2016
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