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PRIDE DETOX LLC
NPI 1003699380
Substance Abuse Rehabilitation Facility in Long Beach, CA

Active since August 18, 2023CLIA 05D2310534 · Waiver
3805 E 15TH ST, LONG BEACH, CA 90804(866) 465-6889(561) 671-7512 Get Directions Write a Review

NPPES record last updated: August 18, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Pride Detox Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PRIDE DETOX LLC (NPI 1003699380) is a healthcare organization registered as a substance abuse rehabilitation facility in Long Beach, California and active in the NPI registry since August 2023. The organization holds a CLIA Waiver certificate valid through September 4, 2026 and lists Donna Weinberger, Ceo, as its authorized official.

NPPES Registry Identity

NPI1003699380
Entity TypeOrganization
Primary Taxonomy324500000X
Legal Business NamePRIDE DETOX LLC
Location Address3805 E 15TH STLong Beach, CA 90804-2944
Mailing Address1414 N D StLake Worth Beach, FL 33460-1761 · (866) 465-6889 · Fax (561) 671-7512
Phone(866) 465-6889
Fax(561) 671-7512
Organization SubpartNo
Authorized OfficialDonna WeinbergerCeo · (561) 460-1318
Enumeration DateAugust 18, 2023
NPPES CertifiedAugust 18, 2023
✔ NPI 1003699380 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySubstance Abuse Rehabilitation FacilityResidential Treatment Facilities
Taxonomy Code324500000X
Definition

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.

Also ListedCommunity/Behavioral HealthTaxonomy 251S00000X
3805 E 15TH ST, Long Beach, CA 90804
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2310534

Pride Detox, LLC · Long Beach, CA
Active · expires Sep 4, 2026
CLIA Number05D2310534
Laboratory TypeSubstance Use Detox Cente
Certificate Effective DateSeptember 5, 2024
Certificate Expiration DateSeptember 4, 2026
Laboratory DirectorJiseung Yoon
Laboratory Phone(866) 465-6889
Laboratory LocationPride Detox, LLC3805 E 15th St, Long Beach, CA 90804
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KACEE M WHEELER AMFT
Marriage & Family Therapist
3805 E 15TH ST
LONG BEACH, CA 90804
Los Angeles County (561) 899-6088

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pride Detox LLC's NPI number?

The NPI number for Pride Detox LLC is 1003699380. It was assigned to this organization in the NPPES registry on August 18, 2023.

Where is Pride Detox LLC located?

Pride Detox LLC is located at 3805 E 15th St, Long Beach, CA 90804. The listed phone number is (866) 465-6889.

What is Pride Detox LLC's specialty?

The primary specialty registered for this NPI is Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.

Does Pride Detox LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2310534) is associated with this NPI, valid through September 4, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Pride Detox LLC was last updated on August 18, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.