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General NPI Number Information
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NPI Number | 1912749235
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Entity Type | Organization
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Legal Business Name | TRUE NORTH DETOX LLC
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Dates
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Enumeration Date | 06/07/2024
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Last Update Date | 02/06/2025
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Provider Practice Location Address
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Address Line | 6271 MR MAGPIE
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City | SHINGLE SPRINGS
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State | CA
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Zip | 95682-8052
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Country | US
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Telephone | 714-417-7628
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Fax |
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Provider Business Mailing Address
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Address Line | 27525 PUERTA REAL STE 100-317
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City | MISSION VIEJO
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State | CA
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Zip | 92691-6379
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Country | US
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Telephone | 714-417-7628
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Fax |
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Authorized Official
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Title or Position | COO
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Name | MR. BENJAMIN BEAUCHAINE
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Credential |
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Telephone | 714-417-7628
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation 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 | 276400000X
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Taxonomy Name | Substance Use Disorder Rehabilitation Hospital Unit
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License Number |
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License Number State |
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Taxonomy #3
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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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