Organization
SOUTH SHORES DETOXLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSH D SMITH (CEO)
(949) 289-2138
Entity
Organization
Contact information
Practice address
27568 VISTA DE DONS, DANA POINT, CA 92624-1843
(949) 218-2347
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
Primary
300324AP
CA
Other
Enumeration date
09/24/2015
Last updated
09/24/2015
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