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
Organization subpart
No

Authorized official

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

Other NPIs on the same Medicare enrollment 7

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

Corporate family (same tax ID) 10

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

Practitioners 69

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 69

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

Medicare participation

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

Medicare enrollment records 1

Medicare enrollment files
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

National Provider Directory

National Provider Directory
Tax ID family
Clare Matrix (11 organizations share this tax ID)

Locations

844 Pico Blvd
Santa Monica, CA 90405
Phone (205) 225-2979

Specialties & licenses 1

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

Addresses

NPPES NPI Registry

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 identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
190016FNOtherCASTATE LICENSE

Other names 1

NPPES NPI Registry
  • Women's Residential Treatment Program Other name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 23, 2023.

{
    "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": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "190016FN",
            "state": "CA"
        }
    ],
    "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.