Provider Demographics
NPI:1215468004
Name:HOPE BY THE SEA
Entity type:Organization
Organization Name:HOPE BY THE SEA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF ADMISSIONS
Authorized Official - Prefix:
Authorized Official - First Name:CYNDIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNKERSON
Authorized Official - Suffix:
Authorized Official - Credentials:CATCIII, CCS
Authorized Official - Phone:949-218-2690
Mailing Address - Street 1:28371 PASEO CERVEZA
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN CAPISTRANO
Mailing Address - State:CA
Mailing Address - Zip Code:92675
Mailing Address - Country:US
Mailing Address - Phone:949-218-2690
Mailing Address - Fax:949-542-8820
Practice Address - Street 1:28371 VIA ANZAR
Practice Address - Street 2:
Practice Address - City:SAN JUAN CAPISTRANO
Practice Address - State:CA
Practice Address - Zip Code:92675-2935
Practice Address - Country:US
Practice Address - Phone:949-218-2690
Practice Address - Fax:949-542-8820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-23
Last Update Date:2017-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA300149AP324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility