BEACHSIDE RECOVERY, LLC – NPI #1710365598
Substance Abuse Rehabilitation Facility

A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

BEACHSIDE RECOVERY, LLC is a substance abuse rehabilitation facility located in FOUNTAIN VALLEY, CA. NPPES has assigned the NPI number 1710365598 to BEACHSIDE RECOVERY, LLC on May 12, 2015. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 324500000X from the Health Care Provider Taxonomy code set, which is classified as Substance Abuse Rehabilitation Facility.

The NPI profile was previously updated about 7 years ago on Dec 10, 2018. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for BEACHSIDE RECOVERY, LLC below.

NPI Profile for
BEACHSIDE RECOVERY, LLC

NPI Number
1710365598
Enumeration Date

(more than 11 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
BEACHSIDE RECOVERY, LLC
Primary location
16490 HARBOR BLVD. A-B
FOUNTAIN VALLEY, CA 92708
Phone: (949) 393-4070 Fax:
Mailing address
PO BOX 511330
LOS ANGELES, CA 90051-7885
Phone: Fax:
Organization Subpart
No
Authorized Official
DARRYLE MACKELVEY
SUPERVISOR
Phone: (714) 948-6086
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
324500000X
- Substance Abuse Rehabilitation Facility (Primary)
CA 300315BP

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.