Organization
SEA CHANGE SANTA MONICA, LP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLE ANDRESS (EXECUTIVE DIRECTOR)
(310) 877-6030
Entity
Organization
Contact information
Practice address
1831 WILSHIRE BLVD, C, SANTA MONICA, CA 90403-5777
(310) 877-6030
Mailing address
212 26TH ST, # 102, SANTA MONICA, CA 90402-2524
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
190831AP
CA
Other
Enumeration date
05/04/2015
Last updated
01/19/2021
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