MEDICARE: BPP CHATWIN, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1578007035
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BPP CHATWIN, LLC

Provider Business Mailing Address
First Line	:	2001 WILSHIRE BLVD
Second Line	:	SUITE 205
City	:	SANTA MONICA
State	:	CA
Zip	:	90403-5641
Country	:	US
Telephone Number	:	310-623-2347
Fax Number	:	323-984-9010

Provider Business Practice Location Address
First Line	:	3849 CHATWIN AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90808-2004
Country	:	US
Telephone Number	:	877-435-7077
Fax Number	:	323-984-9010

Authorized Official
Title or Position	:	VP-FINANCE
Name	:	MR. MICHAEL BRESNICK
Credential	:
Telephone Number	:	310-623-2347

Provider Enumeration Date	:	12/16/2016
Last Update Date	:	12/16/2016

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