Provider Demographics
NPI:1265823751
Name:HILLSIDE LAGUNA BEACH LLC
Entity Type:Organization
Organization Name:HILLSIDE LAGUNA BEACH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:OMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:TURBI
Authorized Official - Suffix:
Authorized Official - Credentials:POST GRADUATE
Authorized Official - Phone:949-233-2828
Mailing Address - Street 1:22981 MILL CREEK DR
Mailing Address - Street 2:BUILDING B
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-1215
Mailing Address - Country:US
Mailing Address - Phone:949-852-9999
Mailing Address - Fax:949-261-9999
Practice Address - Street 1:2516 TEMPLE HILLS DR
Practice Address - Street 2:
Practice Address - City:LAGUNA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92651-2659
Practice Address - Country:US
Practice Address - Phone:949-233-2828
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-05
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility