| Organization Name: | WEST COAST DETOX, INC. |
| NPI Number: | 1063700433 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | REINER NUSBAUM (INSURANCE COORDINATOR) |
| Mailing Address: | 6381 Yale Cir Huntington Beach |
| State: | CA US |
| Postal Code: | 926472557 |
| Phone Number: | 8664482723 |
| Fax Number: | 8667039903 |
| NPI Enumeration Date: | 07/19/2011 |
| NPI Last Update Date: | 07/19/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 324500000X |
| License Number: | 300228AP |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Residential Treatment Facilities |
| Taxonomy Classification: | Substance Abuse Rehabilitation Facility |
| Taxonomy Specialization: | |
| Taxonomy Definition: | 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. |