NPIMap

Organization Active NPI

Pace Recovery Center, LLC

  • Substance Abuse Rehabilitation Facility
  • Newport Beach, CA
National Provider Identifier
1144563396
Registry record updated Nov 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
PACE RECOVERY CENTER, LLC
Practice address
20051 SW Birch St
Newport Beach, CA 92660-1708
Phone
(520) 390-5017
Fax
(949) 490-4053
NPI assigned
Apr 5, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2019

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

Authorized official

Name
Shahan SuzmeyanNPI 1619558962
Title
Cheif Compliance Officer
Phone
(213) 924-6442

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

20051 SW Birch St
Newport Beach, CA 92660-1708

Mailing address

20051 SW Birch St
Newport Beach, CA 92660-1708
Phone (520) 390-5017

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2113779Pace Recovery Center, LLC20051 SW Birch St, Newport Beach, CA 92660Certificate of waiverMay 30, 2028

National Provider Directory

National Provider Directory
Tax ID family
Pace Recovery Center LLC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1365120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574726400000",
    "number": "1144563396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20051 SW BIRCH ST",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926601708",
            "telephone_number": "520-390-5017",
            "fax_number": "949-490-4053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20051 SW BIRCH ST",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926601708",
            "telephone_number": "520-390-5017",
            "fax_number": "949-490-4053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACE RECOVERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-05",
        "last_updated": "2019-11-26",
        "status": "A",
        "authorized_official_last_name": "SUZMEYAN",
        "authorized_official_first_name": "SHAHAN",
        "authorized_official_title_or_position": "CHEIF COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "213-924-6442"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2019; 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.