# WISE &HEALTHY AGING

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134399165
- **Authorized official:** MS. GRACE CHENG BRAUN (PRESIDENT & CEO)
- **Authorized official phone:** (310) 394-9871

## Contact information

- **Practice address:** 1527 4TH ST, 3RD FLOOR, SANTA MONICA, CA 90401-2358
- **Practice address phone:** (310) 394-9871
- **Practice address fax:** (310) 576-2499
- **Mailing address:** 1527 4TH ST, 2ND FLOOR, SANTA MONICA, CA 90401-2358
- **Mailing address phone:** (310) 394-9871
- **Mailing address fax:** (310) 576-2499

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 03/05/2008
- **Last updated:** 09/17/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | W13662 | MEDICARE PROVIDER NUMBER | CA |