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General NPI Number Information
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NPI Number | 1346614666
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Entity Type | Organization
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Legal Business Name | SOUTHERN CALIFORNIA ADDICTION CENTER
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Dates
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Enumeration Date | 11/24/2015
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Last Update Date | 01/26/2018
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Provider Practice Location Address
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Address Line | 36500 DE PORTOLA RD
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City | TEMECULA
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State | CA
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Zip | 92592-7801
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Country | US
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Telephone | 951-302-2481
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Fax |
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Provider Business Mailing Address
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Address Line | 2755 BRISTOL STREET SUITE 140
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City | COSTA MESA
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State | CA
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Zip | 92626
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Country | US
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Telephone | 714-619-5081
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Fax | 206-426-7551
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. AARON BROWER
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Credential |
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Telephone | 714-619-5081
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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 | CA
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