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NPI Code Detail

MEDICARE: THE TEEN PROJECT, INC.

MEDICARE: THE TEEN PROJECT, INC.
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
1261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number : 1588207583
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE TEEN PROJECT, INC.
Provider Business Mailing Address
First Line : 22431 B160 ANTONIO PARKWAY #527
Second Line :
City : RANCHO SANTA MARGARITA
State : CA
Zip : 92688
Country : US
Telephone Number : 949-283-1260
Fax Number : 818-582-8832
Provider Business Practice Location Address
First Line : 30252 TOMAS
Second Line :
City : RANCHO SANTA MARGARITA
State : CA
Zip : 92688-2129
Country : US
Telephone Number : 949-257-8610
Fax Number :
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : LAURI LYNNE BURNS
Credential :
Telephone Number : 818-582-8832
Provider Enumeration Date : 10/22/2019
Last Update Date : 07/21/2025

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Directions to “THE TEEN PROJECT, INC. ” Practice Location

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