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General NPI Number Information
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NPI Number | 1265823751
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Entity Type | Organization
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Legal Business Name | HILLSIDE LAGUNA BEACH LLC
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Dates
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Enumeration Date | 02/05/2015
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Last Update Date | 02/05/2015
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Provider Practice Location Address
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Address Line | 2516 TEMPLE HILLS DR
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City | LAGUNA BEACH
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State | CA
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Zip | 92651-2659
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Country | US
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Telephone | 949-233-2828
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Fax |
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Provider Business Mailing Address
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Address Line | 22981 MILL CREEK DR BUILDING B
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-1215
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Country | US
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Telephone | 949-852-9999
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Fax | 949-261-9999
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Authorized Official
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Title or Position | PRESIDENT & CEO
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Name | MR. OMAR TURBI
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Credential | POST GRADUATE
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Telephone | 949-233-2828
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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