NPIMap

Organization Active NPI

Ede Ca at Santa Monica, LP

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Santa Monica, CA
National Provider Identifier
1033262811
Registry record updated Apr 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
EDE CA AT SANTA MONICA, LP
Practice address
2716 Ocean Park Blvd Ste 3020
Santa Monica, CA 90405-5225
Phone
(310) 829-9161
Fax
(310) 829-9055
NPI assigned
Jan 18, 2007
Organization subpart
Yes
Parent organization
RIVERMEND HEALTH, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 11, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Tyeast Reynolds
Title
Director of RCM
Phone
(678) 813-0428

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

2716 Ocean Park Blvd Ste 3020
Santa Monica, CA 90405-5225

Mailing address

2300 Windy Ridge Parkway
Suite 210S
Atlanta, GA 30339
Phone (470) 440-1647

Other names 1

  • A New Journey Eating Disorder Center Doing business as

National Provider Directory

National Provider Directory

Locations

2716 Ocean Park Blvd
Ste 3020
Santa Monica, CA 90405
Phone 3108299161 ext. 5109

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554940800000",
    "number": "1033262811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 WINDY RIDGE PARKWAY",
            "address_2": "SUITE 210S",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30339",
            "telephone_number": "470-440-1647",
            "fax_number": "310-829-9055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2716 OCEAN PARK BLVD STE 3020",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904055225",
            "telephone_number": "310-829-9161",
            "fax_number": "310-829-9055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDE CA AT SANTA MONICA, LP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RIVERMEND HEALTH, LLC",
        "enumeration_date": "2007-01-18",
        "last_updated": "2019-04-11",
        "status": "A",
        "authorized_official_last_name": "REYNOLDS",
        "authorized_official_first_name": "TYEAST",
        "authorized_official_title_or_position": "DIRECTOR OF RCM",
        "authorized_official_telephone_number": "678-813-0428"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "A New Journey Eating Disorder Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "A New Journey Eating Disorder Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.