Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lake Street Detox LLC

Organization Substance Abuse Rehabilitation Facility · NPI 1891202982

Lake Street Detox LLC is a Substance Abuse Rehabilitation Facility in Huntington Beach, California. Registered with an NPI since 2018.

In the registry since
2018
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

402 Lake St
Huntington Beach, CA 92648-5928
Phone: (877) 699-8511
Fax: (949) 209-2677
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Substance Abuse Rehabilitation Facility (primary) Taxonomy 324500000X

Record details

NPI number1891202982
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Eric Niccole — Ceo · (949) 279-1165
NPI enumeratedJanuary 10, 2018
Last updated in NPPESJanuary 10, 2018
Mailing address402 Lake St, Huntington Beach, CA 92648-5928

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