NPIMap

Organization Active NPI

Gratitude Lodge LLC

  • Substance Abuse Rehabilitation Facility
  • Newport Beach, CA
National Provider Identifier
1992494306
Registry record updated May 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
GRATITUDE LODGE LLC
Practice address
1661 Orchard Dr
Newport Beach, CA 92660-1315
Phone
(800) 994-2184
Fax
(888) 411-0151
NPI assigned
May 2, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2023

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

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

Addresses

Primary practice location

1661 Orchard Dr
Newport Beach, CA 92660-1315

Mailing address

1661 Orchard Dr
Newport Beach, CA 92660-1315

Other names 1

  • Gratitude Lodge Doing business as

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
05D2287914Gratitude Lodge, LLC1661 Orchard Drive, Newport Beach, CA 92660Certificate of waiverAug 17, 2025

National Provider Directory

National Provider Directory
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.

NPI Registry JSON

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

{
    "created_epoch": "1682985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682985600000",
    "number": "1992494306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1661 ORCHARD DR",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926601315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1661 ORCHARD DR",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926601315",
            "telephone_number": "800-994-2184",
            "fax_number": "888-411-0151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRATITUDE LODGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-02",
        "last_updated": "2023-05-02",
        "certification_date": "2023-04-12",
        "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": [
        {
            "organization_name": "Gratitude Lodge",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 2, 2023; 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.