SAN FERNANDO MISSION GROUP HOME (NPI# 1295282739) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295282739 |
| Entity Type | Organization |
| Organization Name | SAN FERNANDO MISSION GROUP HOME |
| Practice Address |
17157 San Fernando Mission Blvd. Granada Hills CA 91344 |
| Mailing Address |
22455 Victory Blvd West Hills CA 91307 |
| Practice Telephone | 8184889046 |
| Practice Fax Number | 8184889046 |
| Mailing Telephone | 8185922960 |
| Mailing Fax Number | 8185922961 |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2016-09-01 |
| Authorized Official Name | MR. JORGE C MARQUEZ (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 8185922960 |
| Is Organization Subpart | Y |
| Parent Organization Name | CHILDREN'S HOMES OF SOUTHERN CALIFORNIA |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | 198208017 | CA | Residential Treatment Facilities |
| Street Address |
17157 SAN FERNANDO MISSION BLVD. |
| City | GRANADA HILLS |
| State | CA |
| Zip Code | 91344 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083230296 | A&e Home Health Care Inc | Home Health | 17631 Chatsworth Street Ste B Room C, Granada Hills, CA 91344 | 2020-06-23 |
| 1710547690 | The Institute for Professional Parenting (tipp) | Psychologist | 15650 Devonshire Street, Suite 210-212, Granada Hills, CA 91344 | 2019-06-13 |
| 1972066934 | Apple Speech and Educational Services, Inc. | Speech-Language Pathologist | 16853 Rinaldi Street, Granada Hills, CA 91344 | 2019-04-08 |
| 1376016642 | Hypnos Sleep Laboratory & Treatement Center, Inc | Clinic/Center | 17050 Chatsworth Blvd. Suite 243, Granada Hills, CA 91344 | 2019-01-09 |
| 1225503543 | Miguel Angel Salas | Naturopath | 10315 Woodley Ave., Suite 103 & 104, Granada Hills, CA 91344 | 2018-10-13 |
| 1790264588 | Ben Maguerrero | Respiratory Therapist, Registered | 16851 Simonds St, Granada Hills, CA 91344 | 2018-08-13 |
| 1265962856 | Safe Med Tranz Inc. | Non-emergency Medical Transport (VAN) | 16000 Horace St, Granada Hills, CA 91344 | 2017-06-15 |
| 1942731302 | Arthur Perez | Physical Therapy Assistant | 11233 Montgomery Ave., Granada Hills, Granada Hills, CA 91344 | 2017-03-27 |
| 1649718990 | Eugene Tan Aguilar | Nurse Practitioner | 16718 San Fernando Mission Blvd, Granada Hills, CA 91344 | 2017-02-07 |
| 1831568815 | Nowelle Gaid Natividad | Physician Assistant | 10535 Collett Ave, Granada Hills, CA 91344 | 2015-09-18 |
| Find all providers in zip 91344 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851847008 | Human Services Network | Residential Treatment Facility, Emotionally Disturbed Children | 17929 Index St, Granada Hills, CA 91344-4018 | 2016-08-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144820499 | Catholic Charities of The Diocese of Oakland | Residential Treatment Facility, Emotionally Disturbed Children | 3700 Dorisa Ave, Oakland, CA 94605-4941 | 2020-10-27 |
| 1922607944 | Inspire A Youth, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 7556 Avenida Baja, Riverside, CA 92509-3449 | 2020-10-21 |
| 1235736554 | Yvonne Dionne Robinson | Residential Treatment Facility, Emotionally Disturbed Children | 1223 E Helmick St, Carson, CA 90746-3163 | 2020-10-09 |
| 1740897784 | Paradise Adolescent Home, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 602 Woodlark Dr, Suisun City, CA 94585-2244 | 2020-09-24 |
| 1548877657 | T & T House of Champions | Residential Treatment Facility, Emotionally Disturbed Children | 2115 High St, Oakland, CA 94601-4335 | 2020-09-23 |
| 1902412182 | Paradise Adolescent Home, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 136 Valdivia Cir, San Ramon, CA 94583-2228 | 2020-09-22 |
| 1073128492 | Samuel Campbell Jr. | Residential Treatment Facility, Emotionally Disturbed Children | 4200 Crescent Rock Ln, Bakersfield, CA 93311-2860 | 2020-09-11 |
| 1336753433 | Aaron's Boys Home | Residential Treatment Facility, Emotionally Disturbed Children | 5805 Capistrano Ave Ste E, Atascadero, CA 93422-7218 | 2020-09-04 |
| 1699389452 | Millie's Youth Services, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 2512 Havenscourt Blvd, Oakland, CA 94605-1935 | 2020-08-31 |
| 1538779871 | Hidden Treasures Foundation, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 1240 W 13th Ave, Escondido, CA 92025-5560 | 2020-08-02 |
| Find all providers with the same taxonomy | ||||
| City | GRANADA HILLS |
| Zip Code | 91344 |
Please comment or provide details below to improve the information on SAN FERNANDO MISSION GROUP HOME.
| 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.