NPIMap

Organization Active NPI

The Beacon House Association of San Pedro

  • Substance Use Disorder Rehabilitation Clinic/Center
  • San Pedro, CA
National Provider Identifier
1104573633
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
THE BEACON HOUSE ASSOCIATION OF SAN PEDRO
Practice address
103 W. 11TH St.
San Pedro, CA 90731-4301
Phone
(310) 514-4940
NPI assigned
Mar 4, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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

Authorized official

Name
Mr. Jonathan Higgins, CATC INPI 1285107946
Title
Chief Compliance Officer
Phone
(310) 514-4940

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary
Substance Abuse Rehabilitation Facility 324500000X

Addresses

Primary practice location

103 W. 11TH St.
San Pedro, CA 90731-4301

Mailing address

PO Box 328
San Pedro, CA 90733-0328
Phone (310) 514-4940

Other practice location 1

411 W 10th St
San Pedro, CA 90731-3213
Phone (310) 514-4940 ext. 861

Other practice location 2

126 W. 10th St.
San Pedro, CA 90731
Phone (310) 514-4940 ext. 861

Other names 1

  • Beacon House Other name

National Provider Directory

National Provider Directory
Tax ID family
Beacon House2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

411 W 10th St
San Pedro, CA 90731
Phone 3105144940 ext. 861

103 W 11th St
San Pedro, CA 90731
Phone (310) 514-4940

Practitioners & affiliated clinicians

Practitioners 7

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": "1646352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720656000000",
    "number": "1104573633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 328",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907330328",
            "telephone_number": "310-514-4940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 W. 11TH ST.",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907314301",
            "telephone_number": "310-514-4940"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "411 W 10th St",
            "address_purpose": "LOCATION",
            "city": "San Pedro",
            "state": "CA",
            "postal_code": "907313213",
            "country_code": "US",
            "telephone_number": "310-514-4940 x861",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "126 W. 10th St.",
            "address_purpose": "LOCATION",
            "city": "San Pedro",
            "state": "CA",
            "postal_code": "90731",
            "country_code": "US",
            "telephone_number": "310-514-4940 x861",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THE BEACON HOUSE ASSOCIATION OF SAN PEDRO",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-04",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A",
        "authorized_official_last_name": "HIGGINS",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "CHIEF COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "310-514-4940",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CATC I"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beacon House",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Beacon House",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Pedro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2024; 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.