WAVELENGTHS RECOVERY INC. NPI 1376923151

NPI Information

NPI: 1376923151
Provider Name: WAVELENGTHS RECOVERY, INC.
Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization

CLIA Number: 05D2222745

Address:
703 CALIFORNIA ST
HUNTINGTON BEACH, CA
ZIP 92648
Phone: (714) 312-1011
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WAVELENGTHS RECOVERY, INC. is a substance abuse rehabilitation facility in Huntington Beach, CA. The provider is 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. WAVELENGTHS RECOVERY, INC. NPI is 1376923151. The provider is registered as an organization entity type.

The provider's business location address is:

703 CALIFORNIA ST
HUNTINGTON BEACH, CA
ZIP 92648-715
Phone: (714) 312-1011
Fax: (949) 629-6833

The provider's authorized official is Warren Boyd .
The authorized official title is Ceo and has the following contact phone number (714) 642-2404.

The CLIA number assigned to this NPI record is 05D2222745 - other - detox/residential with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/5/2015 and was last updated on 12/12/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	324500000X	Substance Abuse Rehabilitation Facility		300323AP	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	300323AP	OTHER	CALIFORNIA	DHCS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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