STANISLAUS COUNTY BHRS (NPI# 1295868305) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295868305 |
| Entity Type | Organization |
| Organization Name | STANISLAUS COUNTY BHRS |
| Other Organization Name | STANISLAUS RECOVERY CENTER |
| Practice Address |
1904 Richland Ave Ceres CA 95307-4562 |
| Mailing Address |
800 Scenic Dr Modesto CA 95350-6131 |
| Practice Telephone | 2095412121 |
| Mailing Telephone | 2095256225 |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2019-10-11 |
| Authorized Official Name | RUBEN IMPERIAL (BEHAVIORAL HEALTH INTERIM DIRECTOR) |
| Authorized Official Telephone | 2095256225 |
| Authorized Official Credential | MBA |
| Is Organization Subpart | Y |
| Parent Organization Name | STANISLAUS COUNTY BHRS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| STANISLAUS RECOVERY CENTER | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467654483 | Stanislaus County Bhrs | Community/Behavioral Health | 1321 I St, Suite 3, Modesto, CA 95354-0902 | 2007-06-01 |
| 1629279823 | Stanislaus County Bhrs | Community/Behavioral Health | 1917 Memorial Dr Ste B, Ceres, CA 95307-1861 | 2007-05-29 |
| 1720111545 | Stanislaus County Bhrs | Community/Behavioral Health | 920 16th St, Suite B & C, Modesto, CA 95354-1119 | 2007-03-13 |
| 1457480642 | Stanislaus County Bhrs | Community/Behavioral Health | 1301 G St, Modesto, CA 95354-2421 | 2007-03-05 |
| 1275735292 | Stanislaus County Bhrs | Community/Behavioral Health | 251 E Hackett Rd, Modesto, CA 95358-9415 | 2007-06-01 |
| 1134320856 | Stanislaus County Bhrs | Community/Behavioral Health | 2215 Blue Gum Ave, Modesto, CA 95358-1052 | 2007-05-30 |
| 1750592184 | Stanislaus County Bhrs | Psychiatry & Neurology | 800 Scenic Dr, Modesto, CA 95350-6131 | 2007-05-25 |
| 1063545473 | Stanislaus County Bhrs | Community/Behavioral Health | 500 N 9th St, Modesto, CA 95350-5814 | 2007-03-14 |
| 1649303546 | Stanislaus County Bhrs | Community/Behavioral Health | 1920 Memorial Dr, Ceres, CA 95307-1827 | 2007-03-13 |
| 1053444877 | Stanislaus County Bhrs | Community/Behavioral Health | 800 Scenic Dr, Modesto, CA 95350-6131 | 2007-03-13 |
| Street Address |
1904 RICHLAND AVE |
| City | CERES |
| State | CA |
| Zip Code | 95307-4562 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174605067 | Kenneth Edwin Richter Jr. | Psychiatry & Neurology | 1904 Richland Ave, Ceres, CA 95307-4562 | 2006-10-19 |
| 1386252807 | Terren Hinojosa | Social Worker | 1904 Richland Ave, Ceres, CA 95307-4562 | 2020-07-21 |
| 1124654447 | James Verma | Technician | 1904 Richland Ave, Ceres, CA 95307-4562 | 2020-03-18 |
| 1144856576 | Randy Lee Freitas | Technician | 1904 Richland Ave, Ceres, CA 95307-4562 | 2020-03-17 |
| 1124651294 | Ash Singh | Registered Nurse | 1904 Richland Ave, Ceres, CA 95307-4562 | 2020-02-18 |
| 1922639038 | Sarah Marie Norwood | Technician | 1904 Richland Ave, Ceres, CA 95307-4562 | 2020-01-28 |
| 1215585716 | Praveena Devi Pal | Registered Nurse | 1904 Richland Ave, Ceres, CA 95307-4562 | 2019-08-28 |
| 1336791052 | Travis Shawn Whitehead | Technician | 1904 Richland Ave, Ceres, CA 95307-4562 | 2019-07-12 |
| 1487212288 | Sandra Elaine Ainslie | Technician | 1904 Richland Ave, Ceres, CA 95307-4562 | 2019-06-05 |
| 1699333153 | Cherish Anne Medeiros | Technician | 1904 Richland Ave, Ceres, CA 95307-4562 | 2019-05-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144762022 | Roxanne Mata | Technician | 1904 Richland Ave., Ceres, CA 95307 | 2016-11-09 |
| 1023496379 | Steven Leonard II | Technician, Other | 1904 Richalnd Ave, Ceres, CA 95307 | 2015-05-07 |
| 1942619820 | Thevi Phanthalangsy | Pharmacist | 1421 Coffee Road, Modesto, CA 95307 | 2014-08-05 |
| 1588973937 | Gloria June Coats | Nurse Practitioner | 3641 Mitchell Road, Suite H, Ceres, CA 95307 | 2010-10-04 |
| 1992953236 | John H Meekay | Dentist | 1788 Mitchell Road Suite 105, Ceres, CA 95307 | 2008-08-28 |
| 1316073778 | Donna J Payne | Case Manager/Care Coordinator | 1904 Richland Avenue, Ceres, CA 95307 | 2007-02-27 |
| 1104994656 | Katherine Anne Kucera | Dentist | 3507 Morgan Rd, Ceres, CA 95307 | 2006-12-01 |
| 1073615084 | Tracy S Park | Dentist | 2760 3rd Street, Suite A, Ceres, CA 95307 | 2006-09-01 |
| 1902855588 | Kerry B Evnin Md Inc A Professional Medical Corporation | Family Medicine | 3641 Mitchell Rd, H, Ceres, CA 95307 | 2006-05-09 |
| 1376012559 | David Andrew Kirkpatrick | Technician | 1904 Richland Ave Bldg D, Ceres, CA 95307 | 2018-11-17 |
| Find all providers in zip 95307 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356684005 | Christine Dianne Long | Substance Abuse Rehabilitation Facility | 1904 Richland Ave, Ceres, CA 95307-4562 | 2013-04-01 |
| 1457480014 | County of Stanislaus | Substance Abuse Rehabilitation Facility | 1904 Richland Ave, Ceres, CA 95307-4562 | 2007-03-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801497359 | California Care Detox & Treatment | Substance Abuse Rehabilitation Facility | 25542 Dana Mesa Dr, San Juan Capistrano, CA 92675-4311 | 2020-11-02 |
| 1952900797 | A Sacred Path | Substance Abuse Rehabilitation Facility | 5671 Spanish Flat Rd, Garden Valley, CA 95633 | 2020-10-22 |
| 1467051672 | Spearhead Health Centers, LLC. | Substance Abuse Rehabilitation Facility | 11704 Wilshire Blvd Ste 226, Los Angeles, CA 90025-1504 | 2020-10-19 |
| 1073111613 | A Place To Heal | Substance Abuse Rehabilitation Facility | 14540 Hamlin St Ste H, Van Nuys, CA 91411-4153 | 2020-10-15 |
| 1871191569 | Old Oak Ranch Recovery Center | Substance Abuse Rehabilitation Facility | 19401 Susan Way, Sonora, CA 95370-9266 | 2020-10-14 |
| 1962009845 | Apex Recovery, LLC | Substance Abuse Rehabilitation Facility | 9952 Grandview Dr, La Mesa, CA 91941-6874 | 2020-10-05 |
| 1376140384 | Magic House Recovery Inc | Substance Abuse Rehabilitation Facility | 1001 S Mountvale Ct, Anaheim, CA 92808-2108 | 2020-10-02 |
| 1942807060 | New Perceptions North, LLC | Substance Abuse Rehabilitation Facility | 5084 N Fruit Ave Ste 105, Fresno, CA 93711-3000 | 2020-10-01 |
| 1346857679 | Apex Recovery, LLC | Substance Abuse Rehabilitation Facility | 3480 Hidden Trail Dr, Jamul, CA 91935-2104 | 2020-09-30 |
| 1992312227 | Apex Recovery, LLC | Substance Abuse Rehabilitation Facility | 2810 Camino Del Rio S Ste 106, San Diego, CA 92108-3819 | 2020-09-30 |
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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.