Healthcare Provider Details

I. General information

NPI: 1750233466
Provider Name (Legal Business Name): CLEAN PATH RECOVERY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2026
Last Update Date: 02/13/2026
Certification Date: 02/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7820 MARINE WAY
IRVINE CA
92618
US

IV. Provider business mailing address

2345 NOTRE DAME RD
COSTA MESA CA
92626-6441
US

V. Phone/Fax

Practice location:
  • Phone: 949-278-1915
  • Fax:
Mailing address:
  • Phone: 949-278-1915
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code276400000X
TaxonomySubstance Use Disorder Rehabilitation Hospital Unit
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: LEE HEILIGMAN
Title or Position: CEO
Credential:
Phone: 949-278-1915