NPIMap

Organization Active NPI

Safe Refuge

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Long Beach, CA
National Provider Identifier
1962828491
Registry record updated Dec 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
190077RN Issued in CA
Legal business name
SAFE REFUGE
Practice address
1046 Redondo Ave
Long Beach, CA 90804-3927
Phone
(562) 987-5722
Fax
(562) 987-4586
NPI assigned
Mar 7, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2014

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

Authorized official

Name
Kathryn Romo
Title
Executive Director
Phone
(562) 987-5722

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 190077RN CA Primary

Addresses

Primary practice location

1046 Redondo Ave
Long Beach, CA 90804-3927

Mailing address

1041 Redondo Ave
Long Beach, CA 90804-3928
Phone (562) 987-5722

Other identifiers 1

IdentifierTypeStateIssuer
1989OtherCADRUG MEDI-CAL

Other names 1

  • Substance Abuse Foundation of Long Beach, Inc. Former legal business name

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
05D2289254Safe Refuge1046 Redondo Ave, Long Beach, CA 90804Certificate of waiverSep 6, 2027
05D2300830Safe Refuge1046 Redondo Avenue, Long Beach, CA 90804Certificate of waiverMar 14, 2028

National Provider Directory

National Provider Directory
Tax ID family
Safe Refuge16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

Locations

1046 Redondo Ave
Long Beach, CA 90804

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1394150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419897600000",
    "number": "1962828491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1041 REDONDO AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908043928",
            "telephone_number": "562-987-5722",
            "fax_number": "562-987-4586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1046 REDONDO AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908043927",
            "telephone_number": "562-987-5722",
            "fax_number": "562-987-4586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAFE REFUGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-07",
        "last_updated": "2014-12-30",
        "status": "A",
        "authorized_official_last_name": "ROMO",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "562-987-5722"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "CA",
            "license": "190077RN",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRUG MEDI-CAL",
            "identifier": "1989",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Substance Abuse Foundation of Long Beach, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.