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RESTORATIVE RESIDENTIAL LLC NPI 1235673963


NPI Information

NPI: 1235673963
Provider Name: RESTORATIVE RESIDENTIAL LLC

Doing Business As: LIGHTFULLY BEHAVIORAL HEALTH

Classification: Community Based Residential Treatment Facility, Mental Illness - 320800000X
Entity Type: Organization

CLIA Number: 05D2285206

Address:
1414 SAN VICENTE BLVD
SANTA MONICA, CA
ZIP 90402
Phone: (885) 762-8088
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RESTORATIVE RESIDENTIAL LLC is a community based residential treatment facility mental illness in Santa Monica, CA. The provider is a home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. RESTORATIVE RESIDENTIAL LLC NPI is 1235673963. The provider is registered as an organization entity type.
The provider Is Doing Business As Lightfully Behavioral Health.

The provider's business location address is:

1414 SAN VICENTE BLVD
SANTA MONICA, CA
ZIP 90402-204
Phone: (885) 762-8088

The provider's authorized official is Tracy Marie Rogers .
The authorized official title is Vp Of Revenue and has the following contact phone number (805) 728-9093.

The CLIA number assigned to this NPI record is 05D2285206 - skilled nursing facility/nursing facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/14/2016 and was last updated on 10/13/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1320800000XCommunity Based Residential Treatment Facility, Mental IllnessYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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