MEDICARE: PACIFIC HILLS TREATMENT CENTERS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	324500000X	Substance Abuse Rehabilitation Facility	300074CP	CA

General Provider Information

NPI Number	:	1043442346
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PACIFIC HILLS TREATMENT CENTERS, INC.

Provider Business Mailing Address
First Line	:	32236 PASEO ADELANTO
Second Line	:	SUITE G
City	:	SAN JUAN CAPISTRANO
State	:	CA
Zip	:	92675-3609
Country	:	US
Telephone Number	:	949-248-5335
Fax Number	:	949-248-4275

Provider Business Practice Location Address
First Line	:	34248 VIA SANTA ROSA
Second Line	:
City	:	CAPISTRANO BEACH
State	:	CA
Zip	:	92624-1121
Country	:	US
Telephone Number	:	949-489-8121
Fax Number	:	949-489-8135

Authorized Official
Title or Position	:	DIRECTOR OF ADMINISTRATION
Name	:	MS. SUSAN KAY SLOAN
Credential	:
Telephone Number	:	949-248-5335

Provider Enumeration Date	:	08/20/2009
Last Update Date	:	08/24/2009

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