Organization
SAFE REFUGE
Active
Other names
Substance Abuse Foundation of Long Beach
Organization subpart
No
Provider details
NPI number
Authorized official
KATHYRN ROMO (EXECUTIVE DIRECTOR)
(562) 987-5722
Entity
Organization
Contact information
Practice address
3113 E 7TH ST, LONG BEACH, CA 90804-4932
(562) 987-5722
(562) 987-4586
Mailing address
1041 REDONDO AVE, LONG BEACH, CA 90804-3928
(562) 987-5722
(562) 987-4586
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
190077CN
CA
324500000X
Substance Abuse Rehabilitation Facility
190077AHN
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1989
MEDI-CAL PROVIDER NUMBER
CA
Enumeration date
11/10/2015
Last updated
11/10/2015
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