Organization
BEACHSIDE RECOVERY LLC
Active
Parent organization
BEACHSIDE RECOVERY LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
BEACHSIDE RECOVERY LLC
Authorized official
PATRICK SMITH (CEO)
(949) 393-4070
Entity
Organization
Contact information
Practice address
1340 N CUSTER ST, SANTA ANA, CA 92701-2506
(949) 393-4070
Mailing address
PO BOX 511330, LOS ANGELES, CA 90051-7885
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
300315IP
CA
Other
Enumeration date
02/21/2018
Last updated
02/21/2018
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