Provider Demographics
NPI:1891530473
Name:LAGUNA BEACH TREATMENT
Entity type:Organization
Organization Name:LAGUNA BEACH TREATMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:DE SANTO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-616-6183
Mailing Address - Street 1:477 CANYON ACRES DR
Mailing Address - Street 2:
Mailing Address - City:LAGUNA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92651
Mailing Address - Country:US
Mailing Address - Phone:626-616-6183
Mailing Address - Fax:
Practice Address - Street 1:477 CANYON ACRES DR
Practice Address - Street 2:
Practice Address - City:LAGUNA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92651
Practice Address - Country:US
Practice Address - Phone:626-616-6183
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LAGUNA BEACH TREATMENT LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility