Dana Point Detox LLC
NPI #1598392417 in Dana Point, California
Provider Information
- NPI Number
- 1598392417
- Entity Type
- Organization
- Organization Name
- Dana Point Detox LLC
- Primary Specialty
- Substance Abuse Rehabilitation Facility
- Enumeration Date
- Mar 23, 2020
- Last Updated
- Jun 9, 2020
Practice Location
- Address
- 24832 LA PAZ AVE APT B
- City
- Dana Point
- State
- California
- ZIP Code
- 92629-5398
- Phone
- (949) 359-5662
Authorized Official
- Name
- MR. NATHANIEL IZZO
- Title
- ADMIN
- Phone
- (949) 359-5662
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinical Medical Laboratory |
| Substance Abuse Rehabilitation Facility |
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