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BH-SD DD OPCO, LLC
NPI 1629627609
Substance Abuse Rehabilitation Facility in San Diego, CA

Active since September 11, 2019CLIA 05D2307779 · Waiver
2456 E ST, SAN DIEGO, CA 92102(858) 254-2510 Get Directions Write a Review

NPPES record last updated: September 11, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Bh-sd Dd Opco, Llc NPPES

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

BH-SD DD OPCO, LLC (NPI 1629627609) is a healthcare organization registered as a substance abuse rehabilitation facility in San Diego, California and active in the NPI registry since September 2019. The organization holds a CLIA Waiver certificate valid through July 14, 2028 and lists Chad Engbrecht, Chief Development Officer, as its authorized official.

NPPES Registry Identity

NPI1629627609
Entity TypeOrganization
Primary Taxonomy324500000X
Legal Business NameBH-SD DD OPCO, LLC
Location Address2456 E STSan Diego, CA 92102-2024
Mailing Address7050 Parkway DrLa Mesa, CA 91942-1535
Phone(858) 254-2510
Organization SubpartNo
Authorized OfficialChad EngbrechtChief Development Officer · (858) 254-2510
Enumeration DateSeptember 11, 2019
✔ NPI 1629627609 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.
2456 E ST, San Diego, CA 92102
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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 05D2307779

Bh-Sd Dd Opco, LLC Dba Jackson House Recovery Center · San Diego, CA
Active · expires Jul 14, 2028
CLIA Number05D2307779
Laboratory TypeComp Resid Rehab Facility
Certificate Effective DateJuly 15, 2026
Certificate Expiration DateJuly 14, 2028
Laboratory DirectorIrinel R. Chiriac
Laboratory Phone(619) 503-7680
Laboratory LocationBh-Sd Dd Opco, LLC Dba Jackson House Recovery Center2456 E St, San Diego, CA 92102
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

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

TYLLINE ANGELIE MORGAN LVN
Licensed Vocational Nurse
2456 E ST
SAN DIEGO, CA 92102
San Diego County (619) 320-4813
WILLIAM HENRY MAZZARELLA JR. COUNSELOR
Registered Nurse (Addiction (Substance Use Disorder))
2456 E ST
SAN DIEGO, CA 92102
San Diego County (619) 503-7680
NADIA LUGUE L.V.N
Licensed Vocational Nurse
2456 E ST
SAN DIEGO, CA 92102
San Diego County (619) 320-4813

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 Bh-Sd Dd Opco, LLC's NPI number?

The NPI number for Bh-Sd Dd Opco, LLC is 1629627609. It was assigned to this organization in the NPPES registry on September 11, 2019.

Where is Bh-Sd Dd Opco, LLC located?

Bh-Sd Dd Opco, LLC is located at 2456 E St, San Diego, CA 92102. The listed phone number is (858) 254-2510.

What is Bh-Sd Dd Opco, LLC's specialty?

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

Does Bh-Sd Dd Opco, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2307779) is associated with this NPI, valid through July 14, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Bh-Sd Dd Opco, LLC was last updated on September 11, 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.