Provider Demographics
NPI:1407346489
Name:TRUE NORTH DETOX LLC
Entity Type:Organization
Organization Name:TRUE NORTH DETOX LLC
Other - Org Name:FIRST STEPS RECOVERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:LAWRENCE
Authorized Official - Last Name:BEAUCHAINE
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT 47103
Authorized Official - Phone:949-584-5957
Mailing Address - Street 1:27525 PUERTA REAL STE 100-316
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-6379
Mailing Address - Country:US
Mailing Address - Phone:844-244-7837
Mailing Address - Fax:
Practice Address - Street 1:2121 HERNDON AVE STE 102
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-6302
Practice Address - Country:US
Practice Address - Phone:844-244-7837
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-15
Last Update Date:2018-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)