| Pride Detox Llc | |
|
3805 E 15th St Long Beach CA 90804-2944 | |
| (866) 465-6889 | |
| (561) 671-7512 |
| Full Name | Pride Detox Llc |
|---|---|
| Speciality | Substance Abuse Rehabilitation Facility |
| Location | 3805 E 15th St, Long Beach, California |
| Authorized Official Name and Position | Donna Weinberger (CEO) |
| Authorized Official Contact | 5614601318 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pride Detox Llc 1414 N D St Lake Worth Beach FL 33460-1761 Ph: (866) 465-6889 | Pride Detox Llc 3805 E 15th St Long Beach CA 90804-2944 Ph: (866) 465-6889 |
| NPI Number | 1003699380 |
|---|---|
| Provider Enumeration Date | 08/18/2023 |
| Last Update Date | 08/18/2023 |
| Certification Date | 08/18/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003699380 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 324500000X | Substance Abuse Rehabilitation Facility | (* (Not Available)) | Primary |
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