Gratitude Lodge LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

GRATITUDE LODGE LLC

Practice address

3849 Chatwin Ave
Long Beach, CA 90808-2004

Phone

(562) 359-6115

NPI assigned

Jul 16, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Mark Williams

Title

Ceo

Phone

(800) 994-2184

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Gratitude Lodge LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

• Gratitude Lodge

  • Substance Abuse Rehabilitation Facility
  • Newport Beach, CA
  • NPI 1598340796
  NPD tax ID
• Gratitude Lodge LLC

  • Substance Abuse Rehabilitation Facility
  • Long Beach, CA
  • NPI 1083479216
  NPD tax ID
• Gratitude Lodge LLC

  • Substance Abuse Rehabilitation Facility
  • Newport Beach, CA
  • NPI 1578193678
  NPD tax ID
• Gratitude Lodge LLC

  dba Gratitude Lodge

  • Substance Abuse Rehabilitation Facility
  • Newport Beach, CA
  • NPI 1992494306
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1531699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708300800000",
    "number": "1033695754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3849 CHATWIN AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908082004",
            "telephone_number": "562-359-6115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3849 CHATWIN AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908082004",
            "telephone_number": "562-359-6115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRATITUDE LODGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-16",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "800-994-2184",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nia Jowan Grant, LPC
• Zariah Grant
• Connie Fay Grantham, D.C.
• Dezon Granville
• Mario Max Granville
• Gratitude Lodge LLC
• Bryon Graulich, ATC, PTA
• Daphne Graves
• Lesley M Graves, PH.D.
• Malaika Elise Graves, M.D.

• Substance Abuse Rehabilitation Facility in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Substance Abuse Rehabilitation Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.