NPIMap

Organization Active NPI

Sea Change Santa Monica, LP

  • Substance Abuse Rehabilitation Facility
  • Santa Monica, CA
National Provider Identifier
1063899524
Registry record updated Jan 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
190831AP Issued in CA
Legal business name
SEA CHANGE SANTA MONICA, LP
Practice address
1831 Wilshire Blvd
C
Santa Monica, CA 90403-5777
Phone
(310) 877-6030
NPI assigned
May 4, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2021

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

Authorized official

Name
Carole Andress
Title
Executive Director
Phone
(310) 877-6030

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 190831AP CA Primary

Addresses

Primary practice location

1831 Wilshire Blvd
C
Santa Monica, CA 90403-5777

Mailing address

212 26TH St
# 102
Santa Monica, CA 90402-2524

National Provider Directory

National Provider Directory
Tax ID family
Sea Change Santa Monica LP3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1430697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611014400000",
    "number": "1063899524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 26TH ST",
            "address_2": "# 102",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904022524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1831 WILSHIRE BLVD",
            "address_2": "C",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904035777",
            "telephone_number": "310-877-6030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEA CHANGE SANTA MONICA, LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-04",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A",
        "authorized_official_last_name": "ANDRESS",
        "authorized_official_first_name": "CAROLE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "310-877-6030"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "190831AP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jan 19, 2021; 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.