Healthcare Provider Details

I. General information

NPI: 1922794023
Provider Name (Legal Business Name): SEEK RECOVERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2023
Last Update Date: 04/12/2023
Certification Date: 04/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23696 BIRTCHER DR
LAKE FOREST CA
92630-1769
US

IV. Provider business mailing address

23696 BIRTCHER DR
LAKE FOREST CA
92630-1769
US

V. Phone/Fax

Practice location:
  • Phone: 949-836-7655
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: KYLE SMITH
Title or Position: CEO
Credential:
Phone: 949-836-7655