NPIMap

Organization Active NPI

Dual Diagnosis Treatment Center, Inc.

  • Substance Abuse Rehabilitation Facility
  • San Clemente, CA
National Provider Identifier
1124394549
Registry record updated Oct 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
DUAL DIAGNOSIS TREATMENT CENTER, INC.
Practice address
601 Calle Real
San Clemente, CA 92673-2624
Phone
(302) 354-9310
NPI assigned
Mar 29, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Tonmoy Sharma
Title
Ceo
Phone
(610) 416-1205

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

601 Calle Real
San Clemente, CA 92673-2624

Mailing address

PO Box 5915
San Clemente, CA 92674-5915
Phone (949) 625-0376

Other names 1

  • Sovereign By The Sea I Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dual Diagnosis Treatment Center Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1332979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603065600000",
    "number": "1124394549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5915",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926745915",
            "telephone_number": "949-625-0376",
            "fax_number": "949-390-9899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 CALLE REAL",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926732624",
            "telephone_number": "302-354-9310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUAL DIAGNOSIS TREATMENT CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-29",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A",
        "authorized_official_last_name": "SHARMA",
        "authorized_official_first_name": "TONMOY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "610-416-1205"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sovereign By The Sea I",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sovereign By The Sea I",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Clemente, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.