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General NPI Number Information
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NPI Number | 1134585730
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Entity Type | Organization
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Legal Business Name | WEST COAST REHAB, LLC
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Dates
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Enumeration Date | 01/12/2016
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Last Update Date | 01/12/2016
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Provider Practice Location Address
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Address Line | 30552 HILLTOP WAY
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City | SAN JUAN CAPISTRANO
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State | CA
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Zip | 92675-2048
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Country | US
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Telephone | 949-218-4141
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Fax | 480-383-6983
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Provider Business Mailing Address
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Address Line | 35 S PEAK
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City | LAGUNA NIGUEL
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State | CA
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Zip | 92677-2903
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Country | US
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Telephone | 949-218-4141
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Fax | 480-383-6983
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Authorized Official
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Title or Position | PRESIDENT / CEO
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Name | MR. DANIEL LEE CASE SR.
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Credential |
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Telephone | 480-612-4297
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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