Provider Demographics
NPI:1851691737
Name:SEACLIFF RECOVERY CENTER
Entity Type:Organization
Organization Name:SEACLIFF RECOVERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DARRYL
Authorized Official - Middle Name:KAZUO
Authorized Official - Last Name:FUJIHARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-960-0078
Mailing Address - Street 1:225 7TH ST
Mailing Address - Street 2:UNIT 2
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-5049
Mailing Address - Country:US
Mailing Address - Phone:714-960-0078
Mailing Address - Fax:
Practice Address - Street 1:18682 BEACH BLVD
Practice Address - Street 2:SUITE 255
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-5049
Practice Address - Country:US
Practice Address - Phone:714-960-0078
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-26
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA300152BP261QR0405X
324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility