| 12 South Recovery | |
|
23712 Birtcher Drive Lake Forest CA 92630 | |
| (888) 830-8374 | |
| (949) 215-6650 |
| Full Name | 12 South Recovery |
|---|---|
| Speciality | Substance Abuse Rehabilitation Facility |
| Location | 23712 Birtcher Drive, Lake Forest, California |
| Authorized Official Name and Position | Kyle Smith (CEO/OWNER) |
| Authorized Official Contact | 8888308374 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 12 South Recovery 23712 Birtcher Drive Lake Forest CA 92630 Ph: (714) 579-9304 | 12 South Recovery 23712 Birtcher Drive Lake Forest CA 92630 Ph: (888) 830-8374 |
| NPI Number | 1154789766 |
|---|---|
| Provider Enumeration Date | 02/10/2016 |
| Last Update Date | 11/02/2022 |
| Certification Date | 11/02/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154789766 | NPI | - | NPPES |
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