Organization
CLARE MATRIX
Active
Other names
Men's Residential Treatment Program, Healing Haven
Organization subpart
No
Provider details
NPI number
Authorized official
MATT WALTON (EXECUTIVE OFFICER)
(310) 314-6200
Entity
Organization
Contact information
Practice address
907-909 PICO BLVD., SANTA MONICA, CA 90405-1326
(310) 314-6200
(310) 450-2024
Mailing address
909 PICO BLVD, SANTA MONICA, CA 90405-1326
(310) 314-6200
(310) 450-2024
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
190016BN
STATE LICENSE
CA
01
—
190016PN
DHCS-AOD STATE LICENSE
CA
Enumeration date
04/30/2010
Last updated
09/20/2024
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