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General NPI Number Information
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NPI Number | 1669199014
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Entity Type | Organization
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Legal Business Name | CLEAR RECOVERY CENTER, LLC
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Dates
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Enumeration Date | 10/26/2022
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Last Update Date | 10/23/2025
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Provider Practice Location Address
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Address Line | 326 N PROSPECT AVE
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City | REDONDO BEACH
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State | CA
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Zip | 90277-3228
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Country | US
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Telephone | 877-899-1985
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Fax | 866-899-1638
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Provider Business Mailing Address
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Address Line | 18119 PRAIRIE AVE
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City | TORRANCE
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State | CA
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Zip | 90504-3739
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Country | US
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Telephone | 877-899-1985
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Fax | 866-899-1638
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Authorized Official
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Title or Position | CMO
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Name | DR. MARTHA BREWER KOO
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Credential | MD
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Telephone | 877-799-1985
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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