Healthcare Provider Details

I. General information

NPI: 1437644457
Provider Name (Legal Business Name): BEACHVIEW TREATMENT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2018
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19126 MAGNOLIA ST STE 201
HUNTINGTON BEACH CA
92646-2249
US

IV. Provider business mailing address

PO BOX 2320
COSTA MESA CA
92628-2320
US

V. Phone/Fax

Practice location:
  • Phone: 253-653-2243
  • Fax: 714-333-4489
Mailing address:
  • Phone: 253-653-2243
  • Fax: 714-603-7416

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DYLAN WALKER
Title or Position: CEO
Credential:
Phone: 949-919-5310