NPIMap

Organization Active NPI

Momentum Detox, LLC

  • Substance Abuse Rehabilitation Facility
  • Huntington Beach, CA
National Provider Identifier
1811694201
Registry record updated Aug 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
MOMENTUM DETOX, LLC
Practice address
17952 Baron Cir Apt 4
Huntington Beach, CA 92647-7153
Phone
(213) 800-5711
NPI assigned
Feb 15, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2024

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

Authorized official

Name
Paul Samson
Title
Ceo
Phone
(949) 603-0989

Specialties & licenses 1

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

Addresses

Primary practice location

17952 Baron Cir Apt 4
Huntington Beach, CA 92647-7153

Mailing address

17952 Baron Cir Apt 4
Huntington Beach, CA 92647-7153
Phone (213) 800-5711

National Provider Directory

National Provider Directory
Tax ID family
Momentum Detox LLC4 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.

NPI Registry JSON

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

{
    "created_epoch": "1676419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723593600000",
    "number": "1811694201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17952 BARON CIR APT 4",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926477153",
            "telephone_number": "213-800-5711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17952 BARON CIR APT 4",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926477153",
            "telephone_number": "213-800-5711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOMENTUM DETOX, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-15",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A",
        "authorized_official_last_name": "SAMSON",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "949-603-0989"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2024; 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.