NEW EXPERIENCE LLC
NPI 1073271011
Substance Abuse Rehabilitation Facility in Fountain Valley, CA

Active since December 07, 2021CLIA 05D2267402 · Waiver
17971 EUCLID ST, FOUNTAIN VALLEY, CA 92708(714) 814-0272 Get Directions Write a Review

NPPES record last updated: March 1, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Mar 1, 2023, Dec 7, 2021 (2 updates tracked since 2021).

  • Organization
  • Substance Abuse Rehabilitation Facility
  • CLIA Number: 05D2267402
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 08-23-2026

About NEW EXPERIENCE LLC

This page provides the complete NPI Profile along with additional information for New Experience Llc, a provider established in Fountain Valley, California operating as a Substance Abuse Rehabilitation Facility. The healthcare provider is registered in the NPI registry with number 1073271011 assigned on December 2021. The practitioner's primary taxonomy code is 324500000X. The provider is registered as an organization and their NPI record was last updated 3 years ago. The authorized official of this NPI record is Ryan Aiumu (Ceo)

NPI
1073271011 Verify this NPI
Provider Name
NEW EXPERIENCE LLC
Entity Type
Organization
Location Address
17971 EUCLID ST FOUNTAIN VALLEY, CA 92708
Location Phone
(714) 814-0272
Mailing Address
PO BOX 2498 COSTA MESA, CA 92628
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
12-07-2021
Last Update Date
03-01-2023
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Substance Abuse Rehabilitation Facility

Taxonomy Code
324500000X
Type
Residential Treatment Facilities
Taxonomy Description
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.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

RYAN AIUMU

Authorized Official Title
CEO
Authorized Official Phone
(714) 814-0272

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
05D2267402
Facility Type
Physician Office
Certificate Effective Date
August 24, 2024
Certificate Expiration Date
August 23, 2026
Laboratory Director
SANJAI THANKACHEN
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to New Experience Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Clinic/Center (Rehabilitation, Substance Use Disorder)
17971 EUCLID ST
FOUNTAIN VALLEY, CA 92708

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1073271011, enumerated as an "organization" on December 07, 2021.

The provider is located at 17971 EUCLID ST FOUNTAIN VALLEY, CA 92708 and the phone number is (714) 814-0272.

Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.