Provider Demographics
NPI:1649699844
Name:TRUE NORTH DETOX LLC
Entity type:Organization
Organization Name:TRUE NORTH DETOX LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
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 300-316
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:559-793-7258
Practice Address - Street 1:22051 OAK HILL LN
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93619-9350
Practice Address - Country:US
Practice Address - Phone:949-584-5957
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-15
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QM0850X, 261QR0405X, 276400000X, 261QM0801X
CA324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)