Shoreline Recovery Center, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

SHORELINE RECOVERY CENTER, LLC

Practice address

2859 El Cajon Blvd
San Diego, CA 92104-1292

Phone

(858) 900-5079

NPI assigned

Apr 30, 2021

Organization subpart

No

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

Authorized official

Name

Robert Wilson

Title

Ceo/LLC Member

Phone

(858) 900-5079

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

Shoreline Recovery Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Shoreline Recovery Center, LLC

  • Community/Behavioral Health Agency
  • Encinitas, CA
  • NPI 1003322033
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Claudio Odilon Cabrejos, MD

  • Psychiatry Physician
  • San Marcos, CA
  • NPI 1033133483
  NPD (past)

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

{
    "created_epoch": "1619740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619740800000",
    "number": "1598348294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "183 CALLE MAGDALENA STE 101",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920243793",
            "telephone_number": "858-900-5079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2859 EL CAJON BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921041292",
            "telephone_number": "858-900-5079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORELINE RECOVERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-30",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-29",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CEO/LLC MEMBER",
        "authorized_official_telephone_number": "858-900-5079"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tarsy Shordon, PA-C
• Amy Shore, MA, MFT
• Tawnia Kristen Shore
• Zachary Shore, O.D.
• Shoreline Companies, LLC
• Christy Melissa Shores, M.S.-CCC, SLP
• Gregory Glen Shorey, MPT, OCS
• Sharon Ann Shorey, OTR
• Abiade Christopher Short, M.D.
• Howard Michael Short, DC

• Community/Behavioral Health Agency in San Diego, CA
• Providers in San Diego, CA by specialty
• Community/Behavioral Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2021; 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.