Healthcare Provider Details
I. General information
NPI: 1649699844
Provider Name (Legal Business Name): TRUE NORTH DETOX LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/15/2014
Last Update Date: 02/06/2025
Certification Date: 02/06/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
22051 OAK HILL LN
CLOVIS CA
93619-9350
US
IV. Provider business mailing address
27525 PUERTA REAL STE 300-316
MISSION VIEJO CA
92691-6379
US
V. Phone/Fax
- Phone: 949-584-5957
- Fax:
- Phone: 844-244-7837
- Fax: 559-793-7258
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QR0405X |
| Taxonomy | Substance Use Disorder Rehabilitation Clinic/Center |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 276400000X |
| Taxonomy | Substance Use Disorder Rehabilitation Hospital Unit |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 324500000X |
| Taxonomy | Substance Abuse Rehabilitation Facility |
| License Number | |
| License Number State | CA |
VIII. Authorized Official
Name: MR.
JOSHUA
BEAUCHAINE
Title or Position: PRESIDENT
Credential: LMFT 47103
Phone: 949-584-5957