MEDICARE: BEACHVIEW TREATMENT, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	324500000X	Substance Abuse Rehabilitation Facility	300072AP	CA

General Provider Information

NPI Number	:	1437644457
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEACHVIEW TREATMENT, LLC

Provider Business Mailing Address
First Line	:	PO BOX 2320
Second Line	:
City	:	COSTA MESA
State	:	CA
Zip	:	92628-2320
Country	:	US
Telephone Number	:	253-653-2243
Fax Number	:	714-603-7416

Provider Business Practice Location Address
First Line	:	19126 MAGNOLIA ST STE 201
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92646-2249
Country	:	US
Telephone Number	:	253-653-2243
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. DYLAN JAMES WALKER
Credential	:
Telephone Number	:	253-653-2243

Provider Enumeration Date	:	06/22/2018
Last Update Date	:	05/27/2026

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