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PACIFIC SHORES RECOVERY LLC
NPI 1588929244
Substance Abuse Rehabilitation Facility in Newport Beach, CA

Active since July 09, 2012CLIA 05D2067488 · Waiver
177 RIVERSIDE AVE, #212, NEWPORT BEACH, CA 92663(949) 574-2510(949) 722-1135 Get Directions Write a Review

NPPES record last updated: July 9, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Pacific Shores Recovery Llc NPPES

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

PACIFIC SHORES RECOVERY LLC (NPI 1588929244) is a healthcare organization registered as a substance abuse rehabilitation facility in Newport Beach, California and active in the NPI registry since July 2012. The organization holds a CLIA Waiver certificate valid through October 15, 2027 and lists Matthew Luchini, Accounts Manager, as its authorized official.

NPPES Registry Identity

NPI1588929244
Entity TypeOrganization
Primary Taxonomy324500000X
Legal Business NamePACIFIC SHORES RECOVERY LLC
Location Address177 RIVERSIDE AVE, #212Newport Beach, CA 92663-4032
Mailing Address177 Riverside Ave, #212Newport Beach, CA 92663-4032 · (949) 574-2510 · Fax (949) 722-1135
Phone(949) 574-2510
Fax(949) 722-1135
Organization SubpartNo
Authorized OfficialMatthew LuchiniAccounts Manager · (928) 533-4220
Enumeration DateJuly 9, 2012
✔ NPI 1588929244 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ 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.
177 RIVERSIDE AVE, Newport Beach, CA 92663
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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 05D2067488

Pacific Shores Recovery · Newport Beach, CA
Active · expires Oct 15, 2027
CLIA Number05D2067488
Laboratory TypeTreatment Facility
Certificate Effective DateOctober 16, 2025
Certificate Expiration DateOctober 15, 2027
Laboratory DirectorMichael Rudolph
Laboratory Phone(949) 200-7307
Laboratory LocationPacific Shores Recovery3309 Clay St, Newport Beach, CA 92663
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

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

THE SONOS GROUP
Specialist
177 RIVERSIDE AVE, F911
NEWPORT BEACH, CA 92663
Orange County (949) 651-3415
EUGENE RICHARD DORSEY MD
Psychiatry & Neurology (Psychiatry)
177 RIVERSIDE AVE
NEWPORT BEACH, CA 92663
Orange County (949) 718-3666

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 Pacific Shores Recovery LLC's NPI number?

The NPI number for Pacific Shores Recovery LLC is 1588929244. It was assigned to this organization in the NPPES registry on July 9, 2012.

Where is Pacific Shores Recovery LLC located?

Pacific Shores Recovery LLC is located at 177 Riverside Ave #212, Newport Beach, CA 92663. The listed phone number is (949) 574-2510.

What is Pacific Shores Recovery LLC's specialty?

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

Does Pacific Shores Recovery LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2067488) is associated with this NPI, valid through October 15, 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 Pacific Shores Recovery LLC was last updated on July 9, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.