NPIMap

Organization Active NPI

San Diego Detox LLC

  • Substance Abuse Rehabilitation Facility
  • Lakeside, CA
National Provider Identifier
1437806395
Registry record updated Sep 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
SAN DIEGO DETOX LLC
Practice address
16916 Deer Hill Ests
Lakeside, CA 92040-1101
Phone
(619) 433-4971
NPI assigned
Mar 9, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2022

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

Authorized official

Name
Thomas Hathorn
Title
Owner/Ceo
Phone
(619) 433-4971

Specialties & licenses 1

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

Addresses

Primary practice location

16916 Deer Hill Ests
Lakeside, CA 92040-1101

Mailing address

7373 University Ave Ste 113
La Mesa, CA 91942-0523

National Provider Directory

National Provider Directory
Tax ID family
San Diego Detox4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

7373 University Ave
Ste 113
La Mesa, CA 91942
Phone (619) 797-7319

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1646784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663804800000",
    "number": "1437806395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7373 UNIVERSITY AVE STE 113",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919420523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16916 DEER HILL ESTS",
            "city": "LAKESIDE",
            "state": "CA",
            "postal_code": "920401101",
            "telephone_number": "619-433-4971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN DIEGO DETOX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-09",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A",
        "authorized_official_last_name": "HATHORN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "619-433-4971"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2022; 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.