Broadway Detox Center LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

BROADWAY DETOX CENTER LLC

Practice address

6021 Jade Cir
Huntington Beach, CA 92647-2246

Phone

(714) 655-0948

NPI assigned

Dec 21, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Shaun Lennert

Title

Chief Operations Officer

Phone

(714) 655-0948

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1450656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450656000000",
    "number": "1831554674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18582 BEACH BLVD",
            "address_2": "STE 214",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926482000",
            "telephone_number": "714-655-0948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6021 JADE CIR",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926472246",
            "telephone_number": "714-655-0948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADWAY DETOX CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-21",
        "last_updated": "2015-12-21",
        "status": "A",
        "authorized_official_last_name": "LENNERT",
        "authorized_official_first_name": "SHAUN",
        "authorized_official_title_or_position": "CHIEF OPERATIONS OFFICER",
        "authorized_official_telephone_number": "714-655-0948",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brightstar Healthcare
• Jonathan Brimley
• Deborah Briones, R.N., N.P.
• Elizabeth Brito, DDS
• Alyce Edythe Britton, PT
• Broadway Treatment Center, LLC
• John Dennis Broderick, M.D.
• Kathryn Broedner, LMFT
• Robert Donald Bronner
• Lea Bronnimann

• Substance Abuse Rehabilitation Facility in Huntington Beach, CA
• Providers in Huntington Beach, 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 Dec 21, 2015; 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.