NPIMap

Organization Active NPI

Beachside Recovery LLC

  • Substance Abuse Rehabilitation Facility
  • Santa Ana, CA
National Provider Identifier
1578063004
Registry record updated Feb 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
300315IP Issued in CA
Legal business name
BEACHSIDE RECOVERY LLC
Practice address
1340 N Custer St
Santa Ana, CA 92701-2506
Phone
(949) 393-4070
NPI assigned
Feb 21, 2018
Organization subpart
Yes
Parent organization
BEACHSIDE RECOVERY LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 21, 2018

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

Authorized official

Name
Patrick Smith
Title
Ceo
Phone
(949) 393-4070

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 300315IP CA Primary

Addresses

Primary practice location

1340 N Custer St
Santa Ana, CA 92701-2506

Mailing address

PO Box 511330
Los Angeles, CA 90051-7885

National Provider Directory

National Provider Directory
Tax ID family
Beachside Recovery Center LLC11 organizations share this tax ID, including this one
Part of
Beachside Recovery Center LLC

Other organizations with this tax ID 10

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

NPI Registry JSON

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

{
    "created_epoch": "1519171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519171200000",
    "number": "1578063004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 511330",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900517885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 N CUSTER ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927012506",
            "telephone_number": "949-393-4070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACHSIDE RECOVERY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BEACHSIDE RECOVERY LLC",
        "enumeration_date": "2018-02-21",
        "last_updated": "2018-02-21",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "949-393-4070"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "300315IP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.