Organization
CLARE MATRIX
Active
Other names
Women's Residential Treatment Program
Organization subpart
No
Provider details
NPI number
Authorized official
STEVE GLICK (CHIEF EXECUTIVE OFFICER)
(310) 314-6200
Entity
Organization
Contact information
Practice address
844 PICO BLVD, SANTA MONICA, CA 90405-1325
(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
190016HN
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
190016FN
STATE LICENSE
CA
Enumeration date
11/06/2012
Last updated
05/23/2023
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