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General NPI Number Information
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NPI Number | 1598472805
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Entity Type | Organization
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Legal Business Name | EXIST CENTERS, LLC
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Dates
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Enumeration Date | 11/04/2022
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 580 BROADWAY ST STE 301
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City | LAGUNA BEACH
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State | CA
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Zip | 92651-4328
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Country | US
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Telephone | 949-891-1308
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Fax | 949-325-2918
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Provider Business Mailing Address
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Address Line | 580 BROADWAY ST STE 301
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City | LAGUNA BEACH
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State | CA
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Zip | 92651-4328
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Country | US
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Telephone | 844-707-2323
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Fax | 949-325-2918
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Authorized Official
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Title or Position | FOUNDER/CCO
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Name | DR. COURTNEY M TRACY
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Credential | LCSW, PSYD
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Telephone | 949-342-6011
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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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