PACIFIC COAST DETOX LLC
NPI 1063375129
Substance Abuse Rehabilitation Facility in San Clemente, CA

Q: What is Pacific Coast Detox LLC's NPI number?

The NPI number for Pacific Coast Detox LLC is 1063375129. It was assigned to this organization in the NPPES registry on December 5, 2025.

Q: What is Pacific Coast Detox LLC's specialty?

The primary specialty registered for this NPI is Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.

Active since December 05, 2025

184 AVENIDA LA CUESTA, SAN CLEMENTE, CA 92672(949) 359-5669 Get Directions Write a Review

NPPES record last updated: January 12, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 12, 2026, Dec 5, 2025 (2 updates tracked since 2025).

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About Pacific Coast Detox Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PACIFIC COAST DETOX LLC (NPI 1063375129) is a healthcare organization registered as a substance abuse rehabilitation facility in San Clemente, California and active in the NPI registry since December 2025. The organization lists Matthew Lee, Admin, as its authorized official.

NPPES Registry Identity

NPI1063375129

Entity TypeOrganization

Primary Taxonomy324500000X

Legal Business NamePACIFIC COAST DETOX LLC

Location Address184 AVENIDA LA CUESTASan Clemente, CA 92672-3142

Mailing Address21263 Doubtful Canyon DrCypress, TX 77433-8470

Phone(949) 359-5669

Organization SubpartNo

Authorized OfficialMatthew LeeAdmin · (619) 987-8078

Enumeration DateDecember 5, 2025

Last NPPES UpdateJanuary 12, 20262 updates tracked since enumeration

NPPES CertifiedJanuary 12, 2026

✔ NPI 1063375129 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySubstance Abuse Rehabilitation FacilityResidential Treatment Facilities

Taxonomy Code324500000X

Definition

A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

184 AVENIDA LA CUESTA, San Clemente, CA 92672

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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BOHICA INVESTMENTS LLC

Substance Abuse Rehabilitation Facility

184 AVENIDA LA CUESTA
SAN CLEMENTE, CA 92672

Orange County (949) 359-5669

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pacific Coast Detox LLC's NPI number?

The NPI number for Pacific Coast Detox LLC is 1063375129. It was assigned to this organization in the NPPES registry on December 5, 2025.

Where is Pacific Coast Detox LLC located?

Pacific Coast Detox LLC is located at 184 Avenida La Cuesta, San Clemente, CA 92672. The listed phone number is (949) 359-5669.

What is Pacific Coast Detox LLC's specialty?

The primary specialty registered for this NPI is Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.

When was this NPI record last updated?

The NPPES record for Pacific Coast Detox LLC was last updated on January 12, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.