BOARDWALK RECOVERY CENTER
NPI 1639677768
Clinic/Center - Rehabilitation, Substance Use Disorder in San Diego, CA
About Boardwalk Recovery Center NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BOARDWALK RECOVERY CENTER (NPI 1639677768) is a healthcare organization registered as a rehabilitation, substance use disorder in San Diego, California and active in the NPI registry since January 2018. The organization lists Amanda Tamai, Executive Assistant, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
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 05D2153187
Boardwalk Recovery Center · San Diego, CAOther Providers at the Same Location NPPES 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Local 92109 LLC's NPI number?
The NPI number for Local 92109 LLC is 1639677768. It was assigned to this organization in the NPPES registry on January 23, 2018. The provider is doing business as Boardwalk Recovery Center.
Where is Local 92109 LLC located?
Local 92109 LLC is located at 1940 Garnet Ave Ste 120, San Diego, CA 92109. The listed phone number is (619) 206-0081.
What is Local 92109 LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Rehabilitation, Substance Use Disorder, with taxonomy code 261QR0405X.
When was this NPI record last updated?
The NPPES record for Local 92109 LLC was last updated on August 15, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.
# Boardwalk Recovery Center · NPI 1639677768
Rehabilitation, Substance Use Disorder organization in San Diego, California. Organization record, active in the CMS NPPES registry since January 23, 2018.
## Identity
- **NPI:** 1639677768 (Entity type: Organization)
- **Enumerated:** January 23, 2018
- **Primary specialty:** Clinic/Center - Rehabilitation, Substance Use Disorder · taxonomy 261QR0405X
- **Legal business name:** Local 92109 Llc
- **Organization subpart:** No
- **Authorized official:** Amanda Tamai, EXECUTIVE ASSISTANT
## Practice location
- **Address:** 1940 GARNET AVE STE 120, San Diego, CA 92109
- **Phone:** (619) 206-0081
## Record status
- **NPPES last updated:** August 15, 2018
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1639677768) · Data from the CMS NPPES public registry.