OrganizationActive
12 South LLC
NPI 1154789766 · Substance Abuse Rehabilitation Facility · Lake Forest, CA
Provider details
- NPI number
- 1154789766
- Entity type
- Organization
- Primary specialty
- Substance Abuse Rehabilitation FacilityResidential Treatment Facilities
- Authorized official
- Kyle Smith, Ceo/Owner
Practice location
23712 Birtcher Drive
Lake Forest, CA 92630
Phone: (888) 830-8374
Fax: (949) 215-6650
Mailing address
23712 Birtcher Drive
Lake Forest, CA 92630
Registry dates
- Enumerated
- 2016-02-10
- Last updated
- 2022-11-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.