Active NPI
West Coast Detox LLC
- Substance Abuse Rehabilitation Facility
- Corona, CA
National Provider Identifier
1215873724
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Substance Abuse Rehabilitation Facility
- Legal business name
- WEST COAST DETOX LLC
- Practice address
- 1180 Cleveland Way
Corona, CA 92881-5905 - Phone
- (866) 758-2862
- NPI assigned
- Apr 27, 2026
- Last updated
- Apr 27, 2026
- Organization subpart
- Yes
- Parent organization
- WEST COAST DETOX LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Bianca Mladinich
- Title
- Cfo
- Phone
- (714) 341-7749
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Substance Abuse Rehabilitation Facility | 324500000X | Primary |
Addresses
Primary practice location
1180 Cleveland Way
Corona, CA 92881-5905
Mailing address
3225 Bighorn Cir
Corona, CA 92881-8747
Phone (866) 758-2862
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D2343281 | West Coast Detox LLC | Certificate of waiver | May 3, 2028 |
National Provider Directory
National Provider Directory- Tax ID family
- West Coast Detox LLC
- Part of
- West Coast Detox LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Substance Abuse Rehabilitation Facility
- Corona, CA
- NPI 1851125876
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1777248000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1777248000000",
"number": "1215873724",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3225 BIGHORN CIR",
"city": "CORONA",
"state": "CA",
"postal_code": "928818747",
"telephone_number": "866-758-2862"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1180 CLEVELAND WAY",
"city": "CORONA",
"state": "CA",
"postal_code": "928815905",
"telephone_number": "866-758-2862"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WEST COAST DETOX LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "WEST COAST DETOX LLC",
"enumeration_date": "2026-04-27",
"last_updated": "2026-04-27",
"certification_date": "2026-04-27",
"status": "A",
"authorized_official_last_name": "MLADINICH",
"authorized_official_first_name": "BIANCA",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "714-341-7749"
},
"taxonomies": [
{
"code": "324500000X",
"taxonomy_group": "",
"desc": "Substance Abuse Rehabilitation Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Corona, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.