1043442346 NPI number — PACIFIC HILLS TREATMENT CENTERS, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043442346 NPI number — PACIFIC HILLS TREATMENT CENTERS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PACIFIC HILLS TREATMENT CENTERS, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1043442346
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/24/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
32236 PASEO ADELANTO
Provider Second Line Business Mailing Address:
SUITE G
Provider Business Mailing Address City Name:
SAN JUAN CAPISTRANO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92675-3609
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
949-248-5335
Provider Business Mailing Address Fax Number:
949-248-4275

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
34248 VIA SANTA ROSA
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CAPISTRANO BEACH
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92624-1121
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
949-489-8121
Provider Business Practice Location Address Fax Number:
949-489-8135
Provider Enumeration Date:
08/20/2009

Additional Information

Authorized Official

Authorized Official Last Name:
SLOAN
Authorized Official First Name:
SUSAN
Authorized Official Middle Name:
KAY
Authorized Official Title or Position:
DIRECTOR OF ADMINISTRATION
Authorized Official Telephone Number:
949-248-5335

Provider Taxonomy Codes

  • Taxonomy code: 324500000X , with the licence number:  300074CP , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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