| 417 San Clemente, Llc | |
|
26010 Acero Ste 200 Mission Viejo CA 92691-6716 | |
| (949) 525-7977 | |
| Not Available |
| Full Name | 417 San Clemente, Llc |
|---|---|
| Speciality | Substance Abuse Rehabilitation Facility - Substance Abuse Treatment, Children |
| Location | 26010 Acero Ste 200, Mission Viejo, California |
| Authorized Official Name and Position | Scott Christian Kalland (OWNER/PRESIDENT) |
| Authorized Official Contact | 9495257977 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 417 San Clemente, Llc 26010 Acero Ste 200 Mission Viejo CA 92691-6716 Ph: (949) 525-7977 | 417 San Clemente, Llc 26010 Acero Ste 200 Mission Viejo CA 92691-6716 Ph: (949) 525-7977 |
| NPI Number | 1770968513 |
|---|---|
| Provider Enumeration Date | 07/22/2015 |
| Last Update Date | 07/02/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770968513 | NPI | - | NPPES |
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