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General NPI Number Information
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NPI Number | 1437644457
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Entity Type | Organization
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Legal Business Name | BEACHVIEW TREATMENT, LLC
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Dates
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Enumeration Date | 06/22/2018
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Last Update Date | 02/21/2023
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Provider Practice Location Address
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Address Line | 19126 MAGNOLIA ST STE 201
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92646-2249
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Country | US
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Telephone | 253-653-2243
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2320
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City | COSTA MESA
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State | CA
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Zip | 92628-2320
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Country | US
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Telephone | 253-653-2243
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Fax | 714-603-7416
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Authorized Official
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Title or Position | CFO
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Name | MR. DYLAN JAMES WALKER
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Credential | CADC-II
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Telephone | 253-653-2243
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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 | 300072AP
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License Number State | CA
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