BEACHSIDE RECOVERY CENTER LLC (NPI# 1427584671) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427584671 |
| Entity Type | Organization |
| Organization Name | BEACHSIDE RECOVERY CENTER LLC |
| Practice Address |
7800 Sw Barbur Blvd Portland OR 97219-2823 |
| Mailing Address |
Po Box 511330 Los Angeles CA 90051-7885 |
| Practice Telephone | 9494307824 |
| Enumeration Date | 2017-05-10 |
| Last Update Date | 2017-05-10 |
| Authorized Official Name | MR. SCOTT WILSON (REGIONAL PROGRAM DIRECTOR) |
| Authorized Official Telephone | 9494307824 |
| Is Organization Subpart | Y |
| Parent Organization Name | BEACHSIDE RECOVERY CENTER LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942714100 | Beachside Recovery Center LLC | Substance Abuse Rehabilitation Facility | 10231 Brier Ln, Santa Ana, CA 92705-1518 | 2017-11-27 |
| 1952815110 | Beachside Recovery Center LLC | Substance Abuse Rehabilitation Facility | 15548 Sonora St, Tustin, CA 92782-1936 | 2017-11-27 |
| 1104330364 | Beachside Recovery Center LLC | Substance Abuse Rehabilitation Facility | 23671 Brasilia St, Mission Viejo, CA 92691-3047 | 2017-11-27 |
| 1346791035 | Beachside Recovery Center LLC | Substance Abuse Rehabilitation Facility | 7800 Sw Barbur Blvd, Portland, OR 97219-2823 | 2016-10-18 |
| Street Address |
7800 SW BARBUR BLVD |
| City | PORTLAND |
| State | OR |
| Zip Code | 97219-2823 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700297074 | Pathfinders of Oregon | Substance Abuse Rehabilitation Facility | 7800 Sw Barbur Blvd, Portland, OR 97219-2823 | 2014-05-08 |
| 1942839493 | Sam Herdman | Behavior Technician | 7800 Sw Barbur Blvd, Portland, OR 97219-2823 | 2020-04-06 |
| 1306475850 | Brittni Ballou-ringo | Behavior Technician | 7800 Sw Barbur Blvd, Portland, OR 97219-2823 | 2020-04-06 |
| 1346791035 | Beachside Recovery Center LLC | Substance Abuse Rehabilitation Facility | 7800 Sw Barbur Blvd, Portland, OR 97219-2823 | 2016-10-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356958672 | Lighthouse Psychological Services, LLC | Psychologist | 630 Sw Nevada St, Ste. E, Poralnd, OR 97219 | 2020-09-30 |
| 1083130991 | Tawayne Nolen Malone Jr. | Psychologist | 0615 Sw Palatine Hill Road, Tawayne Malone - Msc 2159, Portland, OR 97219 | 2017-08-22 |
| 1548667918 | Eleven Eleven, LLC | Specialist/Technologist, Other | 6714 Sw 62nd Place, Portland, OR 97219 | 2014-12-01 |
| 1023414257 | Paul Shayne Hansen | Adult Companion | 9155 Sw 55th Avenue, Portland, OR 97219 | 2014-11-17 |
| 1154721850 | Mikhail Govshievich | Denturist | 9045 Sw Barbur Blvd. Suit 117, Portland, OR 97219 | 2014-08-29 |
| 1255749404 | Kristin Rae Paruszkiewicz | Physical Therapist | 7943 Sw Barbur Blvd #1, Portland, OR 97219 | 2014-07-31 |
| 1639436488 | Michelle Lorraine Emery | Counselor | 7912 Sw 35th, Portland, OR 97219 | 2012-04-18 |
| 1588930192 | Steve Ryan | Speech-Language Pathologist | 3315 Sw Falcon St, Portland, OR 97219 | 2012-03-28 |
| 1104145952 | Multnomah Family Care Center | Clinic/Center | 6787 Sw Capitol Hwy, Portland, OR 97219 | 2010-05-19 |
| 1740518331 | Trilbie L Patteson | Physical Therapy Assistant | 5701 Sw Multnomah Boulevard, West Hills Health and Rehab, Portland, OR 97219 | 2009-11-20 |
| Find all providers in zip 97219 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | 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. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477002228 | Treehouse Nw Inc | Substance Abuse Rehabilitation Facility | 4713 N Albina Ave, Suite 301, Portland, OR 97217-2605 | 2016-09-21 |
| 1154785475 | Blvd Centers, Inc | Substance Abuse Rehabilitation Facility | 1316 Se 12th Ave, Portland, OR 97214-3604 | 2016-04-12 |
| 1104219211 | Allied Health Services | Substance Abuse Rehabilitation Facility | 808 Se Alder St, Portland, OR 97214-2213 | 2015-03-13 |
| 1700297074 | Pathfinders of Oregon | Substance Abuse Rehabilitation Facility | 7800 Sw Barbur Blvd, Portland, OR 97219-2823 | 2014-05-08 |
| 1194037283 | De Paul Treatment Centers | Substance Abuse Rehabilitation Facility | 1312 Sw Washington St., Portland, OR 97208 | 2010-07-06 |
| 1649412511 | Portland Detox | Substance Abuse Rehabilitation Facility | 11160 Sw Waverly Pl, Portland, OR 97225-4456 | 2009-03-24 |
| 1144432907 | Serenity House, Inc. | Substance Abuse Rehabilitation Facility | 30 Mellen St, Portland, ME 04101-2110 | 2007-05-04 |
| 1063548436 | Milestone Foundation Inc | Substance Abuse Rehabilitation Facility | 65 India St, Portland, ME 04101-4209 | 2007-02-27 |
| 1851428775 | Depaul Treatment Centers Inc. | Substance Abuse Rehabilitation Facility | 5052 Ne 42nd Ave, Portland, OR 97218-1550 | 2007-02-27 |
| 1114546645 | Nw Insituto Latino | Substance Abuse Rehabilitation Facility | 2054 N Vancouver Ave, Portland, OR 97227-1917 | 2020-04-14 |
| Find all providers in PORTLAND | ||||
Please comment or provide details below to improve the information on BEACHSIDE RECOVERY CENTER LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.