CANYON AT SANTA MONICA NPI 1891055802

NPI Information

CANYON AT SANTA MONICA is a substance abuse rehabilitation facility in Los Angeles, CA. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. CANYON AT SANTA MONICA NPI is 1891055802. The provider is registered as an organization entity type.

The provider's business location address is:

12304 SANTA MONICA BLVD
SUITE 112
LOS ANGELES, CA
ZIP 90025-551
Phone: (615) 345-3200
Fax: (615) 373-4656

The provider's authorized official is Steve Filton .
The authorized official title is Evp-chief Financial Officer and has the following contact phone number (610) 382-3319.

The CLIA number assigned to this NPI record is 05D2035425 - other - intensive outpatient with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/23/2012 and was last updated on 5/20/2019.

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:

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