MEDICARE: THE CLIMB RECOVERY LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	324500000X	Substance Abuse Rehabilitation Facility
3	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1619649514
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE CLIMB RECOVERY LLC

Provider Business Mailing Address
First Line	:	1968 S COAST HWY STE 1930
Second Line	:
City	:	LAGUNA BEACH
State	:	CA
Zip	:	92651-3681
Country	:	US
Telephone Number	:	714-618-1667
Fax Number	:

Provider Business Practice Location Address
First Line	:	31877 DEL OBISPO ST
Second Line	:
City	:	SAN JUAN CAPISTRANO
State	:	CA
Zip	:	92675-3233
Country	:	US
Telephone Number	:	714-618-1667
Fax Number	:

Authorized Official
Title or Position	:	MANAGING PARTNER
Name	:	CECILIA MUSSEN
Credential	:
Telephone Number	:	714-618-1667

Provider Enumeration Date	:	09/29/2021
Last Update Date	:	09/29/2021

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