Provider Demographics
NPI:1780196733
Name:ACCEPTANCE DETOX LLC
Entity type:Organization
Organization Name:ACCEPTANCE DETOX LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS DEVELOPMENT/MARKETING
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MOVSESIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-205-3659
Mailing Address - Street 1:2619 F ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-1815
Mailing Address - Country:US
Mailing Address - Phone:661-852-4112
Mailing Address - Fax:
Practice Address - Street 1:18779 PALM ST
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-6428
Practice Address - Country:US
Practice Address - Phone:714-369-6232
Practice Address - Fax:844-244-2220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-31
Last Update Date:2017-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction PsychiatryGroup - Single Specialty