LAKE STREET DETOX LLC

HUNTINGTON BEACH, CA
NPI1891202982
Entity TypeOrganization
Authorized ContactERIC NICCOLE
CEO
949-279-1165
Organization Subpart ?No
Primary Taxonomy324500000X Substance Abuse Rehabilitation Facility
Enumeration Date2018-01-10
Last Update Date2018-01-10
Business Address
LAKE STREET DETOX LLC
402 LAKE ST
HUNTINGTON BEACH, CA 92648-5928
Phone number: 877-699-8511
Mailing Address
LAKE STREET DETOX LLC
402 LAKE ST
HUNTINGTON BEACH, CA 92648-5928
Phone number: 877-699-8511
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