Organization
COASTLINE RECOVERY FOR WOMEN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON JACOBS (OWNER)
(949) 345-5577
Entity
Organization
Contact information
Practice address
18377 BEACH BLVD, SUITE 330, HUNTINGTON BEACH, CA 92648-1381
(949) 345-5577
Mailing address
18377 BEACH BLVD, SUITE 330, HUNTINGTON BEACH, CA 92648-1381
(949) 345-5577
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
03/28/2017
Last updated
03/28/2017
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