Socal Detox, LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

SOCAL DETOX, LLC

Doing business as

SOCAL DETOX

Practice address

31959 Virginia Way
Laguna Beach, CA 92651-6822

Phone

(949) 336-1313

Fax

(949) 276-8442

NPI assigned

Jun 3, 2016

Organization subpart

No

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

Authorized official

Name

Josh Beauchaine, LMFT

Title

President

Phone

(949) 584-5957

Specialties & licenses 1

Addresses

Other names 1

• SOCAL DETOX Doing business as

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

  • Substance Abuse Rehabilitation Facility
  • San Clemente, CA
  • NPI 1255750519
  NPD tax ID

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

{
    "created_epoch": "1464912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644883200000",
    "number": "1871941583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31959 VIRGINIA WAY",
            "city": "LAGUNA BEACH",
            "state": "CA",
            "postal_code": "926516822",
            "telephone_number": "949-336-1313",
            "fax_number": "949-276-8442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31959 VIRGINIA WAY",
            "city": "LAGUNA BEACH",
            "state": "CA",
            "postal_code": "926516822",
            "telephone_number": "949-336-1313",
            "fax_number": "949-276-8442"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "31957 Virginia Way",
            "address_purpose": "LOCATION",
            "city": "Laguna Beach",
            "state": "CA",
            "postal_code": "926516822",
            "country_code": "US",
            "telephone_number": "949-336-1313",
            "fax_number": "949-276-8442",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOCAL DETOX, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-03",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-15",
        "status": "A",
        "authorized_official_last_name": "BEAUCHAINE",
        "authorized_official_first_name": "JOSH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-584-5957",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOCAL DETOX",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SOCAL DETOX",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tracey Slater, MS, CCC-SLP
• Edward L Smith, D.O.
• Keri Loraine Smith, B.S.
• Taylor Smith
• Timothy Snyder, DPT
• Solace Recovery
• Soul Path Wellness Inc.
• South Coast Eye Care Centers
• South Coast Medical Center
• South Coast Medical Center

• Substance Abuse Rehabilitation Facility in Laguna Beach, CA
• Providers in Laguna 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 Feb 15, 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.