Organization
ORANGE COUNTY DETOX
Active
Other names
Orange County Rehab
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH NERSTEN (ADMINISTRATOR)
(213) 344-8804
Entity
Organization
Contact information
Practice address
546 HAMILTON ST, COSTA MESA, CA 92627-2617
(949) 548-0801
Mailing address
546 HAMILTON ST, COSTA MESA, CA 92627-2617
(949) 548-0801
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
300169BP
CA
Other
Enumeration date
10/08/2015
Last updated
10/08/2015
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