THE BEACON HOUSE ASSOCIATION OF SAN PEDRO NPI 1104573633

NPI Information

  • NPI: 1104573633
  • Provider Name: THE BEACON HOUSE ASSOCIATION OF SAN PEDRO
  • Classification: Clinic/Center - 261QR0405X
  • Specialization: Rehabilitation, Substance Use Disorder
  • Entity Type: Organization
  • Other Name: BEACON HOUSE
  • Address: 103 W. 11TH ST.
    SAN PEDRO, CA
    ZIP 90731
  • Phone: (310) 514-4940

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NPI Details

THE BEACON HOUSE ASSOCIATION OF SAN PEDRO is a rehabilitation and substance use disorder clinic center in San Pedro, CA. THE BEACON HOUSE ASSOCIATION OF SAN PEDRO NPI is 1104573633. The provider is registered as an organization entity type.
The provider Other Name Is Beacon House.

The provider's business location address is:

103 W. 11TH ST.
SAN PEDRO, CA
ZIP 90731-301
Phone: (310) 514-4940

The provider's authorized official is Jonathan Higgins .
The authorized official title is Chief Compliance Officer and has the following contact phone number (310) 514-4940.

The enumeration date for this NPI number is 3/4/2022 and was last updated on 7/11/2024.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QR0405XClinic/CenterRehabilitation, Substance Use DisorderYes
2324500000XSubstance Abuse Rehabilitation FacilityNo

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: 3/30/2025

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