CITADEL COMMUNITY CARE FACILITIES (NPI# 1134693153) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134693153 |
| Entity Type | Organization |
| Organization Name | CITADEL COMMUNITY CARE FACILITIES |
| Practice Address |
568 N Mountain View Ave San Bernardino CA 92401-1231 |
| Practice Telephone | 9099920929 |
| Mailing Telephone | 9099920929 |
| Enumeration Date | 2019-01-12 |
| Last Update Date | 2019-01-12 |
| Authorized Official Name | ANNETTE PUNIMATA (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 9099920929 |
| Is Organization Subpart | Y |
| Parent Organization Name | CITADEL COMMUNITY DEVELOPMENT CORPORATION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | Residential Treatment Facilities | ||
| N | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities | ||
| N | 3245S0500X |
Substance Abuse Rehabilitation Facility Specialization: Substance Abuse Treatment, Children |
Residential Treatment Facilities | ||
| N | 253J00000X | Foster Care Agency | Agencies | ||
| N | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities | ||
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities | ||
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities | ||
| N | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities | ||
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | CITADEL COMMUNITY CARE FACILITIES | 568 N Mountain View Ave, San Bernardino, CA 92401-1231 |
| Street Address |
568 N MOUNTAIN VIEW AVE |
| City | SAN BERNARDINO |
| State | CA |
| Zip Code | 92401-1231 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043784069 | Citadel Short Term Specialty Treatment Programs | Case Management | 568 N Mountain View Ave, San Bernardino, CA 92401-1231 | 2019-01-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649885468 | Eagles Wings Hospice, LLC | Hospice Care, Community Based | 255 N. D Street, Suite 200-xix, San Bernardino, CA 92401 | 2020-09-09 |
| 1457831398 | Omar Torres | Case Manager/Care Coordinator | 574 N Arrowhead Ave., San Bernardino, CA 92401 | 2018-08-20 |
| 1104354539 | Llesenia Aleman | Case Manager/Care Coordinator | 597 North Arrowhead Ave, San Bernardino, CA 92401 | 2017-05-30 |
| 1669916193 | Yvonne Castro | Marriage & Family Therapist | 572 N. Arrowhead Ave., Suite 200, San Bernardino, CA 92401 | 2016-12-19 |
| 1811342132 | Maria Teresa Rodriguez Cortes | Counselor | 572 N. Arrowhead Ave. Suite 100, San Bernardino, CA 92401 | 2016-04-25 |
| 1841603339 | Kelly Michelle Cottingham | Licensed Practical Nurse | 350 W. Fifth Street, Suite 212, San Bernardino, CA 92401 | 2014-06-03 |
| 1558781245 | Desiree Inez Harris | Counselor | 572 N Arrowhead Ave #200, San Bernardino, CALIFORNIA 92401 | 2014-04-21 |
| 1194159970 | Sabrina Shrita Thakur | Marriage & Family Therapist | 572 N Arrowhead, San Bernardino, CA 92401 | 2013-08-28 |
| 1770845497 | Youths' Hope Licensed Clinical Social Worker Inc | Counselor | 255 N. D Street, Suite 400, San Bernardino, CA 92401 | 2012-06-08 |
| 1235461427 | Erin Nicole Stines | Recreation Therapist | 572 N. Arrowhead Ave. Suite 200, San Bernardino, CA 92401 | 2010-02-12 |
| Find all providers in zip 92401 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528688892 | Berhe Group Home Inc. | Community/Behavioral Health | 5994 Mckinley Ave, San Bernardino, CA 92404-3530 | 2020-04-16 |
| 1902436744 | Koinonia Foster Homes, Inc. | Community/Behavioral Health | 1881 Business Center Dr Ste 10, San Bernardino, CA 92408-3465 | 2020-01-21 |
| 1750931572 | County of San Bernardino | Community/Behavioral Health | 351 N Mt View Ave San Bernardino Ca 92415, San Bernardino, CA 92415-0001 | 2019-09-13 |
| 1922579598 | Expert Aba Consulting | Community/Behavioral Health | 3975 Modesto Dr, San Bernardino, CA 92404-1946 | 2018-12-07 |
| 1619452547 | County of San Bernardino | Community/Behavioral Health | 900 E Gilbert St Bldg 31, San Bernardino, CA 92415-0911 | 2018-09-26 |
| 1558878819 | Latasha Shenise Jones | Community/Behavioral Health | 2030 E 19th St Apt C, San Bernardino, CA 92404-5800 | 2018-01-08 |
| 1609392729 | Berhe Group Home, Inc. | Community/Behavioral Health | 1604 N Pennsylvania Ave, San Bernardino, CA 92411-1171 | 2017-08-21 |
| 1003331018 | Bianka Elsie Sanchez | Community/Behavioral Health | 7812 Merito Ave, San Bernardino, CA 92410-4631 | 2017-08-10 |
| 1821511908 | Wendy Martinez | Community/Behavioral Health | 5550 University Pkwy, San Bernardino, CA 92407-2318 | 2017-07-20 |
| 1801319124 | Ernesto Alonso | Community/Behavioral Health | 325 W Hospitality Ln Ste 104, San Bernardino, CA 92408-3210 | 2017-07-18 |
| Find all providers in SAN BERNARDINO | ||||
| City | SAN BERNARDINO |
| Zip Code | 92401 |
Please comment or provide details below to improve the information on CITADEL COMMUNITY CARE FACILITIES.
| 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.