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LIGHTFULLY BEHAVIORAL HEALTH
NPI 1235673963
Community Based Residential Treatment Facility, Mental Illness in Santa Monica, CA

Active since December 14, 2016CLIA 05D2285206 · Waiver
1414 SAN VICENTE BLVD, SANTA MONICA, CA 90402(885) 762-8088 Get Directions Write a Review

NPPES record last updated: October 13, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Aug 23, 2024, Oct 13, 2022, Aug 16, 2022 and 5 more (8 updates tracked since 2016).

About Lightfully Behavioral Health NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LIGHTFULLY BEHAVIORAL HEALTH (NPI 1235673963) is a healthcare organization registered as a community based residential treatment facility, mental illness in Santa Monica, California and active in the NPI registry since December 2016. The organization holds a CLIA Waiver certificate valid through July 6, 2027, maintains a secondary practice location in Beverly Hills, and lists Tracy Marie Rogers, Vp Of Revenue, as its authorized official.

NPPES Registry Identity

NPI1235673963
Entity TypeOrganization
Primary Taxonomy320800000X
Legal Business NameRESTORATIVE RESIDENTIAL LLC
Location Address1414 SAN VICENTE BLVDSanta Monica, CA 90402-2204
Mailing AddressPo Box 969Holly Springs, NC 27540-0969 · (916) 352-7997 · Fax (916) 352-7997
Phone(885) 762-8088
Organization SubpartNo
Authorized OfficialTracy Marie RogersVp Of Revenue · (805) 728-9093
Enumeration DateDecember 14, 2016
Last NPPES UpdateOctober 13, 20228 updates tracked since enumeration
NPPES CertifiedOctober 13, 2022
✔ NPI 1235673963 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity Based Residential Treatment Facility, Mental IllnessResidential Treatment Facilities
Taxonomy Code320800000X
Definition

A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.

1414 SAN VICENTE BLVD, Santa Monica, CA 90402
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Other Names 1

Doing Business AsLightfully Behavioral Health

Secondary Practice Location 1

Location 19714 Oak Pass RdBeverly Hills, CA 90210-1223 · Phone (888) 576-2808

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2285206

Lightfully Behavorial Health - Sol · Santa Monica, CA
Active · expires Jul 6, 2027
CLIA Number05D2285206
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateJuly 7, 2025
Certificate Expiration DateJuly 6, 2027
Laboratory DirectorKathryn Hirst
Laboratory Phone(818) 483-0865
Laboratory LocationLightfully Behavorial Health - Sol1414 San Vicente Blvd, Santa Monica, CA 90402
CLIA data matches this NPI record on: Address
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Restorative Residential LLC's NPI number?

The NPI number for Restorative Residential LLC is 1235673963. It was assigned to this organization in the NPPES registry on December 14, 2016. The provider is doing business as Lightfully Behavioral Health.

Where is Restorative Residential LLC located?

Restorative Residential LLC is located at 1414 San Vicente Blvd, Santa Monica, CA 90402. The listed phone number is (885) 762-8088.

What is Restorative Residential LLC's specialty?

The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Mental Illness with taxonomy code 320800000X.

Does Restorative Residential LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2285206) is associated with this NPI, valid through July 6, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Restorative Residential LLC was last updated on October 13, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.