DANA POINT DETOX LLC (NPI# 1598392417) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598392417 |
| Entity Type | Organization |
| Organization Name | DANA POINT DETOX LLC |
| Practice Address |
24832 La Paz Ave Apt B Dana Point CA 92629-5398 |
| Practice Telephone | 9493595662 |
| Practice Fax Number | 9495423878 |
| Enumeration Date | 2020-03-23 |
| Last Update Date | 2020-06-09 |
| Authorized Official Name | MR. NATHANIEL IZZO (ADMIN) |
| Authorized Official Telephone | 9493595662 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 291U00000X | Clinical Medical Laboratory | Laboratories | ||
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | STATE OF CA | 300392AP | 01 |
| CLIA | 05D2183497 | 01 |
| Street Address |
24832 LA PAZ AVE APT B |
| City | DANA POINT |
| State | CA |
| Zip Code | 92629-5398 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003443144 | Torrey Dawn Commisso | Counselor | 34092 Violet Lantern, Suite 100, Dana Point, CA 92629 | 2020-03-26 |
| 1104466473 | Kirsten Noelle Yackley | Marriage & Family Therapist | 34202 Del Obispo, Dana Point, CA 92629 | 2020-01-14 |
| 1154971653 | Alicia Jolieta Ciriani | Technician | 25082 Perch Dr., Dans Point, CA 92629 | 2019-09-17 |
| 1821640137 | L Snyder Incorporated | Family Medicine | 34052 La Plaza #101, Dana Point, CA 92629 | 2019-07-16 |
| 1023572609 | Michelle Shickler | Behavioral Analyst | 32565 Golden Lantern Suite B #180, Dana Point, CA 92629 | 2019-01-28 |
| 1649734427 | Gustavo Asencia | Behavioral Analyst | 32565 Golden Lantern Ste B180, Dana Point, CA 92629 | 2019-01-25 |
| 1275069684 | Mission Rehab, LLC. | Substance Abuse Rehabilitation Facility | 32656 Golden Lantern, Suite B #473, Dana Point, CA 92629 | 2017-05-04 |
| 1922548452 | Dana Point Rehab Campus | Substance Abuse Rehabilitation Facility | 33842 Orilla Rd, Dana Point, CA 92629 | 2017-03-02 |
| 1316340060 | Steven Edward Dunbar | Chiropractor | 32585 Golden Lantern St. Suite H, Dana Point, CA 92629 | 2014-10-08 |
| 1427476183 | Lorraine Ann Sherrie | Occupational Therapy Assistant | 24242 La Cresta, Ot Department, Dana Point, CA 92629 | 2014-03-31 |
| Find all providers in zip 92629 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881256071 | Sunshine Behavioral Health LLC | Substance Abuse Rehabilitation Facility | 35072 Camino Capistrano, Dana Point, CA 92624-1731 | 2019-07-08 |
| 1104380047 | Ocean Hills Recovery Inc. | Substance Abuse Rehabilitation Facility | 34469 Camino El Molino, Dana Point, CA 92624-1070 | 2019-01-24 |
| 1023581691 | Oceanway Treatment Center, LLC | Substance Abuse Rehabilitation Facility | 35492 Del Rey, Dana Point, CA 92624-1836 | 2019-01-07 |
| 1851802458 | Alexandra Rose Corporation | Substance Abuse Rehabilitation Facility | 35402 Camino Capistrano, Dana Point, CA 92624-1805 | 2017-10-23 |
| 1275069684 | Mission Rehab, LLC. | Substance Abuse Rehabilitation Facility | 32656 Golden Lantern, Suite B #473, Dana Point, CA 92629 | 2017-05-04 |
| 1306370192 | Luminance Health Group, Inc. | Substance Abuse Rehabilitation Facility | 24662 El Camino Capistrano, Dana Point, CA 92629-3012 | 2017-04-18 |
| 1215468681 | Ocean Hills Recovery, Inc | Substance Abuse Rehabilitation Facility | 33402 Palo Alto St, Dana Point, CA 92629-1435 | 2017-03-27 |
| 1831620202 | Ocean Hills Recovery Inc. | Substance Abuse Rehabilitation Facility | 34062 Amber Lantern St, Dana Point, CA 92629-2522 | 2017-03-27 |
| 1699216903 | Ocean Hills Recovery Inc. | Substance Abuse Rehabilitation Facility | 33701 Big Sur St, Dana Point, CA 92629-2011 | 2017-03-20 |
| 1922548452 | Dana Point Rehab Campus | Substance Abuse Rehabilitation Facility | 33842 Orilla Rd, Dana Point, CA 92629 | 2017-03-02 |
| Find all providers in DANA POINT | ||||
| City | DANA POINT |
| Zip Code | 92629 |
Please comment or provide details below to improve the information on DANA POINT DETOX LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.