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General NPI Number Information
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NPI Number | 1801497359
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Entity Type | Organization
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Legal Business Name | CALIFORNIA CARE DETOX & TREATMENT
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Dates
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Enumeration Date | 11/02/2020
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Last Update Date | 02/03/2022
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Provider Practice Location Address
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Address Line | 26452 ARACENA DR
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City | MISSION VIEJO
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State | CA
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Zip | 92691-5102
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Country | US
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Telephone | 949-291-3333
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Fax |
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Provider Business Mailing Address
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Address Line | 27068 LA PAZ RD # 649
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City | ALISO VIEJO
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State | CA
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Zip | 92656-3041
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Country | US
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Telephone | 949-291-3333
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Fax | 209-917-8608
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Authorized Official
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Title or Position | CEO
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Name | JASON BOUQUET
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Credential |
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Telephone | 949-291-3333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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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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