NPIMap

Organization Active NPI

House of Metamorphosis, Inc.

  • Substance Abuse Rehabilitation Facility
  • San Diego, CA
National Provider Identifier
1114049186
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
370021AN Issued in CA
Legal business name
HOUSE OF METAMORPHOSIS, INC.
Practice address
2970 Market St
San Diego, CA 92102-3241
Phone
(619) 236-9217
Fax
(619) 232-0855
NPI assigned
Apr 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Beverly MonroeNPI 1902310220
Title
Executive Director
Phone
(619) 236-9217

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 370021AN CA Primary

Addresses

Primary practice location

2970 Market St
San Diego, CA 92102-3241

Mailing address

2970 Market St
San Diego, CA 92102-3241
Phone (619) 236-9217

National Provider Directory

National Provider Directory

Locations

2970 Market St
San Diego, CA 92102
Phone (619) 236-9217

Practitioners & affiliated clinicians

Practitioners 29

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114049186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2970 MARKET ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921023241",
            "telephone_number": "619-236-9217",
            "fax_number": "619-232-0855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2970 MARKET ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921023241",
            "telephone_number": "619-236-9217",
            "fax_number": "619-232-0855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOUSE OF METAMORPHOSIS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MONROE",
        "authorized_official_first_name": "BEVERLY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "619-236-9217",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "370021AN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.