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Active
Organization subpart
No

Provider details

NPI number
Authorized official
MATT WALTON (INTERIM EXECUTIVE DIRECTOR)
(310) 314-6200
Entity
Organization

Contact information

Practice address
909 PICO BLVD, SANTA MONICA, CA 90405-1326
(310) 314-6200
Mailing address
909 PICO BLVD, SANTA MONICA, CA 90405-1326
(310) 314-6200

Taxonomy

Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary

Other

Enumeration date
12/20/2018
Last updated
08/19/2024
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