The Breakers of Long Beach Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

197801971 Issued in CA

Legal business name

THE BREAKERS OF LONG BEACH INC.

Practice address

210 E Ocean Blvd
Long Beach, CA 90802-4853

Phone

(562) 432-6700

Fax

(562) 435-0544

NPI assigned

Nov 2, 2013

Organization subpart

Yes

Parent organization

SIGN OF THE DOVE INC.As reported in NPPES

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

Authorized official

Name

Chris Colgan

Title

Chief Financial Officer

Phone

(818) 713-0155

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1383350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383350400000",
    "number": "1326477159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22900 VENTURA BLVD STE 200",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913641279",
            "telephone_number": "818-713-0155",
            "fax_number": "818-713-8266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 E OCEAN BLVD",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908024853",
            "telephone_number": "562-432-6700",
            "fax_number": "562-435-0544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE BREAKERS OF LONG BEACH INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SIGN OF THE DOVE INC.",
        "enumeration_date": "2013-11-02",
        "last_updated": "2013-11-02",
        "status": "A",
        "authorized_official_last_name": "COLGAN",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "818-713-0155"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CA",
            "license": "197801971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Long Beach, CA
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2013; 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.