12 South LLC
NPI #1154789766 in Lake Forest, California
Provider Information
- NPI Number
- 1154789766
- Entity Type
- Organization
- Organization Name
- 12 South LLC
- Primary Specialty
- Substance Abuse Rehabilitation Facility
- Enumeration Date
- Feb 10, 2016
- Last Updated
- Nov 2, 2022
Practice Location
- Address
- 23712 BIRTCHER DRIVE
- City
- Lake Forest
- State
- California
- ZIP Code
- 92630
- Phone
- (888) 830-8374
Authorized Official
- Name
- KYLE SMITH
- Title
- CEO/OWNER
- Phone
- (888) 830-8374
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder) |
| Marriage & Family Therapist |
| Substance Abuse Rehabilitation Facility |
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