Healthcare Provider Details

I. General information

NPI: 1518619733
Provider Name (Legal Business Name): SOLACE TREATMENT CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2022
Last Update Date: 11/22/2024
Certification Date: 11/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13027 HADLEY ST
WHITTIER CA
90601-4206
US

IV. Provider business mailing address

6709 WASHINGTON AVE # 9047
WHITTIER CA
90601-4326
US

V. Phone/Fax

Practice location:
  • Phone: 833-903-3334
  • 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 TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ISAAC MARTINEZ
Title or Position: CEO
Credential:
Phone: 562-471-6769