CRESTWOOD BEHAVIORAL HEALTH, INC. (NPI# 1093892663) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093892663 |
| Entity Type | Organization |
| Organization Name | CRESTWOOD BEHAVIORAL HEALTH, INC. |
| Other Organization Name | BRIDGE PROGRAM - FRESNO |
| Practice Address |
153 N U St Fresno CA 93701-2438 |
| Mailing Address |
7590 Shoreline Dr Stockton CA 95219-5455 |
| Practice Telephone | 5594459094 |
| Practice Fax Number | 5594459083 |
| Mailing Telephone | 2099552328 |
| Mailing Fax Number | 2099525314 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2015-05-21 |
| Authorized Official Name | MRS. LORI BLACKBURN (VICE PRESIDENT) |
| Authorized Official Telephone | 2099552322 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| BRIDGE PROGRAM - FRESNO | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487282273 | Crestwood Behavioral Health, Inc. | Intermediate Care Facility, Mental Illness | 303 S C St, Lompoc, CA 93436-7305 | 2020-03-29 |
| 1023495181 | Crestwood Behavioral Health, Inc. | Intermediate Care Facility, Mental Illness | 960 Third Ave, Chula Vista, CA 91911 | 2015-04-28 |
| 1295146934 | Crestwood Behavioral Health, Inc. | Intermediate Care Facility, Mental Illness | 5550 University Ave Ste A, San Diego, CA 92105 | 2014-05-15 |
| 1780009142 | Crestwood Behavioral Health, Inc. | Psychiatric Hospital | 2201 Tuolumne St Ste B, Vallejo, CA 94589-2524 | 2014-02-21 |
| 1669734075 | Crestwood Behavioral Health, Inc. | Psychiatric Hospital | 2600 Stockton Blvd Ste B, Sacramento, CA 95817-2210 | 2012-06-12 |
| 1194034645 | Crestwood Behavioral Health, Inc. | Psychiatric Hospital | 6700 Eucalyptus Dr Ste C, Bakersfield, CA 93306-6075 | 2010-10-01 |
| 1821269093 | Crestwood Behavioral Health, Inc. | Psychiatric Hospital | 6700 Eucalyptus Dr, Suite B, Bakersfield, CA 93306-6075 | 2008-03-17 |
| 1275668840 | Crestwood Behavioral Health, Inc. | Clinic/Center | 409 N Adams St, Dixon, CA 95620-2925 | 2007-02-22 |
| 1073648747 | Crestwood Behavioral Health, Inc. | Clinic/Center | 1945 Kidder Ave, Fairfield, CA 94533-3919 | 2007-02-22 |
| 1356411656 | Crestwood Behavioral Health, Inc. | Intermediate Care Facility, Mental Illness | 2600 Stockton Blvd, Sacramento, CA 95817-2210 | 2006-11-08 |
| Street Address |
153 N U ST |
| City | FRESNO |
| State | CA |
| Zip Code | 93701-2438 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295342699 | Matthew Donlon | Case Manager/Care Coordinator | 153 N U St, Fresno, CA 93701-2438 | 2020-09-29 |
| 1306471966 | Alec Mccandless | Case Manager/Care Coordinator | 153 N U St, Fresno, CA 93701-2438 | 2020-03-04 |
| 1437783628 | Allyson Robertson | Counselor | 153 N U St, Fresno, CA 93701-2438 | 2020-02-26 |
| 1841824349 | Jerry Xavier Hernandez | Counselor | 153 N U St, Fresno, CA 93701-2438 | 2020-02-24 |
| 1366075970 | Jessica Salinas | Case Manager/Care Coordinator | 153 N U St, Fresno, CA 93701-2438 | 2020-02-21 |
| 1588297212 | David Hunter | Counselor | 153 N U St, Fresno, CA 93701-2438 | 2020-02-21 |
| 1376176016 | Julio Gamboa | Counselor | 153 N U St, Fresno, CA 93701-2438 | 2020-02-21 |
| 1821628843 | Kinda Colbert | Counselor | 153 N U St, Fresno, CA 93701-2438 | 2020-01-17 |
| 1013547066 | Noeum Daniel | Counselor | 153 N U St, Fresno, CA 93701-2438 | 2020-01-17 |
| 1710527940 | Sia Xiong-lopez | Counselor | 153 N U St, Fresno, CA 93701-2438 | 2020-01-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134740244 | Tamara Sue Stanic | Registered Nurse | 215 N. Fresno Street, Suite 370, Fresno, CA 93701 | 2020-04-29 |
| 1144849829 | Katelyn Nicole Van Leir | Student in an Organized Health Care Education/Training Program | Surabian Dental Care Center - Suite 2500, 290 N. Wayte Lane, Fresno, CA 93701 | 2020-04-13 |
| 1003445693 | Michelle Edwardson | Registered Nurse | 215 North Fresno Street, Suite 370, Fresno, CA 93701 | 2020-04-06 |
| 1184253924 | Patricia Calderon | Registered Nurse | 215 N. Fresno Street, Suite 230, Fresno, CA 93701 | 2020-04-03 |
| 1922637032 | Leticia Lopez | Registered Nurse | 215 N. Fresno Street, Suite 230, Fresno, CA 93701 | 2020-04-02 |
| 1275026585 | Yesenia Gonzalez | Nurse Practitioner | 311 Abby Street, Fresno, CA 93701 | 2018-06-11 |
| 1710474606 | Amanda Juarez | Dietitian, Registered | 215 N Fresno, Suite 370, Fresno, CA 93701 | 2018-04-17 |
| 1235650391 | Plastic Surgery Partners of Fresno Inc | Plastic Surgery | 215 N Fresno St, Ste 490, Fresno, CA 93701 | 2017-06-29 |
| 1205369790 | Amy Alagh | Student in an Organized Health Care Education/Training Program | 155 N Fresno Street, Fresno, CA 93701 | 2017-04-11 |
| 1922462159 | Henry Matthew Dunn | Student in an Organized Health Care Education/Training Program | Ucsf Fresno, 155 N. Fresno St., Department of Orthopaedic Surgery, Fresno, CA 93701 | 2016-04-13 |
| Find all providers in zip 93701 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326645904 | New Passages Group Home, Inc. | Community Based Residential Treatment Facility, Mental Illness | 5675 E Ashlan Ave, Fresno, CA 93727-7220 | 2020-10-06 |
| 1467060053 | Michigan House Inc. | Community Based Residential Treatment Facility, Mental Illness | 1224 E Michigan Ave, Fresno, CA 93704-5731 | 2020-07-20 |
| 1346877594 | 2nd Home Incorporated | Community Based Residential Treatment Facility, Mental Illness | 3239 E Tenaya Way, Fresno, CA 93710-5924 | 2020-03-26 |
| 1174185722 | Dn Associates | Community Based Residential Treatment Facility, Mental Illness | 3793 N Polk Ave, Fresno, CA 93722-9763 | 2019-07-03 |
| 1770143646 | Core Conditions, Inc. | Community Based Residential Treatment Facility, Mental Illness | 3765 W Dakota Ave, Fresno, CA 93722-4784 | 2019-06-13 |
| 1891354023 | Core Conditions, Inc. | Community Based Residential Treatment Facility, Mental Illness | 114 S Brawley Ave, Fresno, CA 93706-2103 | 2019-06-11 |
| 1245725506 | Promesa Behavioral Health-barstow | Community Based Residential Treatment Facility, Mental Illness | 1415 W Barstow Ave, Fresno, CA 93711 | 2018-06-28 |
| 1972112563 | Michigan House Inc. | Community Based Residential Treatment Facility, Mental Illness | 1209 S Hughes Ave, Fresno, CA 93706-2321 | 2020-07-29 |
| 1063021921 | Hope for Youth, Inc. | Community Based Residential Treatment Facility, Mental Illness | 4324 W Harvard Ave, Fresno, CA 93722-5183 | 2020-07-27 |
| 1033727326 | Manuch Inc. | Community Based Residential Treatment Facility, Mental Illness | 5610 W Donner Ave, Fresno, CA 93722-3721 | 2020-07-22 |
| Find all providers in FRESNO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.