Socal Detox, LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

TBD Issued in CA

Legal business name

SOCAL DETOX, LLC

Practice address

1703 Avenida Salvador
San Clemente, CA 92672-3268

Phone

(949) 584-5957

Fax

(360) 323-7285

NPI assigned

Apr 15, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Joshua Lawrence Beauchaine, LMFT 47103

Title

President

Phone

(949) 584-5957

Specialties & licenses 1

Addresses

Tax ID family

Socal Detox2 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.

• Socal Detox, LLC

  dba Socal Detox

  • Substance Abuse Rehabilitation Facility
  • Laguna Beach, CA
  • NPI 1871941583
  NPD tax ID

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

{
    "created_epoch": "1397520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397520000000",
    "number": "1255750519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1703 AVENIDA SALVADOR",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926723268",
            "telephone_number": "949-584-5957",
            "fax_number": "360-323-7285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1703 AVENIDA SALVADOR",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926723268",
            "telephone_number": "949-584-5957",
            "fax_number": "360-323-7285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOCAL DETOX, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-15",
        "last_updated": "2014-04-15",
        "status": "A",
        "authorized_official_last_name": "BEAUCHAINE",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "LAWRENCE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-584-5957",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMFT 47103"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "TBD",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elyse Edler Snipes, M.A.
• Sobertec LLC
• Sobertec LLC
• Sobertec LLC
• Sobriety Support Solutions (Thors Treatment Center)
• Victoria Joy Soneff
• Krista Sornborger, DPT
• South County Addiction Treatment Services, Inc. (Orange County Addiction Treatment Services)
• South County Urgent Care Medical Corporation
• South Oc Wellness

• Substance Abuse Rehabilitation Facility in San Clemente, CA
• Providers in San Clemente, CA by specialty
• Substance Abuse Rehabilitation Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2014; 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.