Klean Long Beach, Wa, LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

KLEAN LONG BEACH, WA, LLC

Practice address

211 Pioneer Rd W
Long Beach, WA 98631-3654

Phone

(360) 642-3105

Fax

(360) 642-2766

NPI assigned

Jan 22, 2013

Organization subpart

No

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

Authorized official

Name

Andrew Spanswick

Title

Ceo

Phone

(310) 435-8096

Specialties & licenses 1

Addresses

Tax ID family

Klean Long Beach Wa Bellvue2 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.

• Klean Long Beach, Wa LLC.

  • Substance Abuse Rehabilitation Facility
  • Bellevue, WA
  • NPI 1831526920
  NPD tax ID

Locations

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

{
    "created_epoch": "1358812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399852800000",
    "number": "1912245259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 W SUNSET BLVD",
            "address_2": "650 B",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900695801",
            "telephone_number": "310-740-4843",
            "fax_number": "310-657-4420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 PIONEER RD W",
            "city": "LONG BEACH",
            "state": "WA",
            "postal_code": "986313654",
            "telephone_number": "360-642-3105",
            "fax_number": "360-642-2766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KLEAN LONG BEACH, WA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-22",
        "last_updated": "2014-05-12",
        "status": "A",
        "authorized_official_last_name": "SPANSWICK",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-435-8096"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jael T Johnson
• Jessica Jolly
• Jason Kagie, BA OF PSYCHOLOGY
• Michelle Kemmer
• Destini Kirkwood, LMHCA, AAC
• Klean Physicians Group, LLC.
• Anna Marie Klingler
• Grant P Kolb
• Travis Krueger
• Jereen Laferriere

• Substance Abuse Rehabilitation Facility in Long Beach, WA
• Providers in Long Beach, WA by specialty
• Substance Abuse Rehabilitation Facility in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2014; 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.