Clear Detox Center Inc.

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

300372AP Issued in CA

Legal business name

CLEAR DETOX CENTER INC.

Practice address

552 Hamilton St
Unit E1
Costa Mesa, CA 92627-5570

Phone

(949) 200-7555

NPI assigned

Apr 23, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Kenneth Nersten

Title

Ceo

Phone

(949) 200-7555

Specialties & licenses 1

Addresses

Other names 1

• Clear Treatment Other name

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

{
    "created_epoch": "1492905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492905600000",
    "number": "1356876767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "546 HAMILTON ST",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926272617",
            "telephone_number": "949-200-7555",
            "fax_number": "949-548-0804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "552 HAMILTON ST",
            "address_2": "UNIT E1",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926275570",
            "telephone_number": "949-200-7555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEAR DETOX CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-23",
        "last_updated": "2017-04-23",
        "status": "A",
        "authorized_official_last_name": "NERSTEN",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "949-200-7555",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "300372AP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clear Treatment",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Substance Abuse Rehabilitation Facility in Costa Mesa, CA
• Providers in Costa Mesa, 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 23, 2017; 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.