Healthcare Provider Details

I. General information

NPI: 1598472805
Provider Name (Legal Business Name): EXIST CENTERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2022
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31642 COAST HWY STE 202
LAGUNA BEACH CA
92651-7017
US

IV. Provider business mailing address

31642 COAST HWY STE 202
LAGUNA BEACH CA
92651-7017
US

V. Phone/Fax

Practice location:
  • Phone: 844-707-2323
  • Fax: 949-325-2918
Mailing address:
  • Phone: 844-707-2323
  • Fax: 949-325-2918

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: DR. COURTNEY M TRACY
Title or Position: FOUNDER/CCO
Credential: LCSW, PSYD
Phone: 949-342-6011