Organization · NPI-2

12 North LLC

Substance Abuse Rehabilitation Facility · Lake Forest, CA

NPI number1174137467
StatusActive
Last updated in NPPESSep 3, 2020

Details

NPI
1174137467
Entity type
Organization (NPI-2)
Legal business name
12 North LLC
Organization subpart
No
Enumeration date
Sep 3, 2020
Certification date
Sep 3, 2020
Last updated
Sep 3, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
324500000X Substance Abuse Rehabilitation Facility––Yes

Practice location

23696 Birtcher Dr
Lake Forest, CA 92630-1769

Phone 888-830-8374 · Fax 949-215-6650

Mailing address

23696 Birtcher Dr
Lake Forest, CA 92630-1769

Phone 888-830-8374 · Fax 949-215-6650

Authorized official

Becky Tolmasoff
Hr Manager
9494137554

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