MEDICARE: CLEAN PATH RECOVERY, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251S00000X	Community/Behavioral Health Agency
2	324500000X	Substance Abuse Rehabilitation Facility
3	177F00000X	Lodging Provider

General Provider Information

NPI Number	:	1538784319
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLEAN PATH RECOVERY, LLC

Provider Business Mailing Address
First Line	:	1650 ADAMS AVE
Second Line	:
City	:	COSTA MESA
State	:	CA
Zip	:	92626-4958
Country	:	US
Telephone Number	:	949-278-1915
Fax Number	:

Provider Business Practice Location Address
First Line	:	929 S TOWNSEND ST
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92704-2925
Country	:	US
Telephone Number	:	949-734-7432
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	LEE HEILIGMAN
Credential	:
Telephone Number	:	949-278-1915

Provider Enumeration Date	:	06/08/2020
Last Update Date	:	02/10/2026

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Directions to “CLEAN PATH RECOVERY, LLC ” Practice Location

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