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BEACHSIDE RECOVERY LLC
NPI 1093223877
Substance Abuse Rehabilitation Facility in Santa Ana, CA

Active since January 16, 2018CLIA 05D2292410 · Waiver
12668 GREENWALD LN, SANTA ANA, CA 92705(949) 393-4070 Get Directions Write a Review

NPPES record last updated: October 28, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 28, 2019, Jan 16, 2018 (2 updates tracked since 2018).

About Beachside Recovery Llc NPPES

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

BEACHSIDE RECOVERY LLC (NPI 1093223877) is a healthcare organization registered as a substance abuse rehabilitation facility in Santa Ana, California and active in the NPI registry since January 2018. The organization holds a CLIA Waiver certificate valid through October 24, 2027 and lists Darryle Mackelvey, Supervisor, as its authorized official.

NPPES Registry Identity

NPI1093223877
Entity TypeOrganization
Primary Taxonomy324500000X
Legal Business NameBEACHSIDE RECOVERY LLC
Location Address12668 GREENWALD LNSanta Ana, CA 92705-1498
Mailing AddressPo Box 511330Los Angeles, CA 90051-7885
Phone(949) 393-4070
Organization SubpartYes
Authorized OfficialDarryle MackelveySupervisor · (714) 948-6086
Enumeration DateJanuary 16, 2018
Last NPPES UpdateOctober 28, 20192 updates tracked since enumeration
✔ NPI 1093223877 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySubstance Abuse Rehabilitation FacilityResidential Treatment Facilities
Taxonomy Code324500000X
License✔ Licensed in CA · 300315JP
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.
12668 GREENWALD LN, Santa Ana, CA 92705
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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 05D2292410

Beachside Recovery Center · Santa Ana, CA
Active · expires Oct 24, 2027
CLIA Number05D2292410
Laboratory TypeIndependent
Certificate Effective DateOctober 25, 2025
Certificate Expiration DateOctober 24, 2027
Laboratory DirectorRandall Turner
Laboratory Phone(949) 933-7608
Laboratory LocationBeachside Recovery Center10231 Brier Lane, Santa Ana, CA 92705
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

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 Beachside Recovery LLC's NPI number?

The NPI number for Beachside Recovery LLC is 1093223877. It was assigned to this organization in the NPPES registry on January 16, 2018.

Where is Beachside Recovery LLC located?

Beachside Recovery LLC is located at 12668 Greenwald Ln, Santa Ana, CA 92705. The listed phone number is (949) 393-4070.

What is Beachside Recovery LLC's specialty?

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

Does Beachside Recovery LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2292410) is associated with this NPI, valid through October 24, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Beachside Recovery LLC was last updated on October 28, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.