Provider Demographics
NPI:1437644457
Name:BEACHVIEW TREATMENT, LLC
Entity type:Organization
Organization Name:BEACHVIEW TREATMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:DYLAN
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:CADC-II
Authorized Official - Phone:253-653-2243
Mailing Address - Street 1:PO BOX 2320
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92628-2320
Mailing Address - Country:US
Mailing Address - Phone:253-653-2243
Mailing Address - Fax:714-603-7416
Practice Address - Street 1:19126 MAGNOLIA ST STE 201
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92646-2249
Practice Address - Country:US
Practice Address - Phone:253-653-2243
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-22
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA300072AP324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility