GRATITUDE LODGE NPI 1598340796

NPI Information

NPI: 1598340796
Provider Name: GRATITUDE LODGE
Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization
Address:
20132 REDLANDS DR
NEWPORT BEACH, CA
ZIP 92660
Phone: (781) 330-2124
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GRATITUDE LODGE is a substance abuse rehabilitation facility in Newport 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. GRATITUDE LODGE NPI is 1598340796. The provider is registered as an organization entity type.

The provider's business location address is:

20132 REDLANDS DR
NEWPORT BEACH, CA
ZIP 92660-324
Phone: (781) 330-2124

The provider's authorized official is Mark Williams .
The authorized official title is Co Founder and has the following contact phone number (781) 330-2124.

The enumeration date for this NPI number is 3/10/2021 and was last updated on 3/10/2021.

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	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder			No
2	324500000X	Substance Abuse Rehabilitation Facility				Yes

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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