NPIMap

Organization Active NPI

Clare Matrix

  • Substance Abuse Rehabilitation Facility
  • Santa Monica, CA
National Provider Identifier
1851645394
Registry record updated May 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
190016HN Issued in CA
Legal business name
CLARE MATRIX
Practice address
844 Pico Blvd
Santa Monica, CA 90405-1325
Phone
(310) 314-6200
Fax
(310) 450-2024
NPI assigned
Nov 6, 2012
Last updated
May 23, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2023

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

Authorized official

Name
Steve Glick
Title
Chief Executive Officer
Phone
(310) 314-6200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 190016HN CA Primary

Addresses

Primary practice location

844 Pico Blvd
Santa Monica, CA 90405-1325

Mailing address

909 Pico Blvd
Santa Monica, CA 90405-1326
Phone (310) 314-6200

Other names 1

  • Women's Residential Treatment Program Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210615001248 CA Part B Supplier - Clinic/Group Practice 1850791757 Receives reassigned benefits from 4 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ontario, CA; Santa Monica, CA

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2131175Women's Treatment Program844 Pico Blvd, Santa Monica, CA 90405Certificate of waiverMay 22, 2027

National Provider Directory

National Provider Directory
Tax ID family
Clare Matrix11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Locations

844 Pico Blvd
Santa Monica, CA 90405
Phone 3103146200 ext. 3576

Practitioners & affiliated clinicians

Practitioners 73

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 73

NPI Registry JSON

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

{
    "created_epoch": "1352160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684800000000",
    "number": "1851645394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 PICO BLVD",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904051326",
            "telephone_number": "310-314-6200",
            "fax_number": "310-450-2024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "844 PICO BLVD",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904051325",
            "telephone_number": "310-314-6200",
            "fax_number": "310-450-2024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARE MATRIX",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-06",
        "last_updated": "2023-05-23",
        "certification_date": "2023-05-23",
        "status": "A",
        "authorized_official_last_name": "GLICK",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "310-314-6200"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "190016HN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Women's Residential Treatment Program",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 May 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.