Organization
SEA CHANGE RECOVERY 2 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA MCMAHON (COMPLIANCE)
(619) 871-7345
Entity
Organization
Contact information
Practice address
1831 WILSHIRE BLVD STE CANDC2, SANTA MONICA, CA 90403-5777
(949) 244-5481
Mailing address
2973 HARBOR BLVD STE 140, COSTA MESA, CA 92626-3912
(949) 244-5481
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
03/28/2023
Last updated
03/28/2023
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