MR. JEREMY CHARLES MCCRACKEN


Address: 714 West Main Street, Grass Valley, CA 95945
Phone: 5304779800

MR. JEREMY CHARLES MCCRACKEN (NPI# 1538586821) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1538586821
Entity Type Individual
Full Name MR. JEREMY CHARLES MCCRACKEN
Practice Address 714 West Main Street
Grass Valley
CA 95945
Practice Telephone 5304779800
Mailing Telephone 5304779800
Mailing Fax Number 5304779803
Enumeration Date 2014-03-25
Last Update Date 2014-04-15
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 322D00000X Residential Treatment Facility, Emotionally Disturbed Children Residential Treatment Facilities

Office Location

Street Address 714 WEST MAIN STREET
City GRASS VALLEY
State CA
Zip Code 95945

Providers in the same location

NPI Name Taxonomy Address Enumeration
1316377369 Michelene Arielle-nicole Stringer Residential Treatment Facility, Emotionally Disturbed Children 714 West Main Street, Grass Valley, CA 95945 2013-11-12
1225505209 Kurt William Picillo Counselor 714 West Main Street, Grass Valley, CA 95945 2018-10-29
1871910166 Desiree Cain Counselor 714 West Main Street, Grass Valley, CA 95945 2014-03-25
1306262555 Thomas Joseph Leonard Residential Treatment Facility, Emotionally Disturbed Children 714 West Main Street, Grass Valley, CA 95945 2014-03-12
1336565589 Kristi Louise Hoopes Residential Treatment Facility, Emotionally Disturbed Children 714 West Main Street, Grass Valley, CA 95945 2014-03-12
1528484771 Teresa M. Garcilaso Residential Treatment Facility, Emotionally Disturbed Children 714 West Main Street, Grass Valley, CA 95945 2014-03-12
1265863039 Lacie Renae Belding Residential Treatment Facility, Emotionally Disturbed Children 714 West Main Street, Grass Valley, CA 95945 2013-12-04

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1568028595 Rae Meyer Bastoni Chiropractor 124 Clydesdale Ct, Ste. K, Grass Valley, CA 95945 2019-05-15
1255815221 Victoria M Goddard Counselor 900 East Main St Suite 201, Grass Valley, CA 95945 2018-09-17
1912488503 Janell Dawn Jones Pharmacist 10106 East Dr, Grass Valley, CA 95945 2018-08-22
1184114779 Evan Ariel Walters Physical Therapist 104 Magaret Lane, Grass Valley, CA 95945 2018-05-18
1295199420 Allyssa Fennelly Skowyra Chiropractor 155 Spring Hill Dr Ste 201, Grass Valley, CA 95945 2016-04-13
1326417627 Nevada County Crisis Stabilization Unit Clinic/Center 145 Glasson Way, Grass Valley, CA 95945 2015-09-17
1942607957 California Mental Health Counselor 120 N. Auburn Street, Ste 212, Grass Valley, CA 95945 2014-11-20
1740611615 Jarrett M Weiss Residential Treatment Facility, Emotionally Disturbed Children 714 W. Main Street, Grass Valley, CA 95945 2013-12-03
1669802732 Nicole Marie Sullivan Residential Treatment Facility, Emotionally Disturbed Children 714 W Main Street, Grass Valley, CA 95945 2013-11-26
1396171450 Linda Kay Williams-coleman Physical Therapy Assistant 10654 Walker Dr, Grass Valley, CA 95945 2013-09-20
Find all providers in zip 95945

Taxonomy Information

Taxonomy Code 322D00000X
Grouping Residential Treatment Facilities
Classification Residential Treatment Facility, Emotionally Disturbed Children

Taxonomy Definition

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.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1740611615 Jarrett M Weiss Residential Treatment Facility, Emotionally Disturbed Children 714 W. Main Street, Grass Valley, CA 95945 2013-12-03
1669802732 Nicole Marie Sullivan Residential Treatment Facility, Emotionally Disturbed Children 714 W Main Street, Grass Valley, CA 95945 2013-11-26
1316377369 Michelene Arielle-nicole Stringer Residential Treatment Facility, Emotionally Disturbed Children 714 West Main Street, Grass Valley, CA 95945 2013-11-12
1497907075 Rick Edward Beberg Residential Treatment Facility, Emotionally Disturbed Children 714 West St., Grass Valley, CA 95945 2008-10-15
1932321221 Charis Youth Center Residential Treatment Facility, Emotionally Disturbed Children 13668 Auburn Rd, Grass Valley, CA 95949-8760 2007-05-03
1083836472 Deborah Joy Gilcrest Residential Treatment Facility, Emotionally Disturbed Children 714 W. Main St., Grass Valley, CA 95945 2007-05-03
1891917365 Charis Youth Center Residential Treatment Facility, Emotionally Disturbed Children 17036 Bissell Place, Grass Valley, CA 95949 2007-05-03
1659593101 Charis Youth Center Residential Treatment Facility, Emotionally Disturbed Children 12875 Rattlesnake Rd, Grass Valley, CA 95945 2007-05-03
1356562748 Cristine Davis Residential Treatment Facility, Emotionally Disturbed Children 10171 Comerate Rd, Grass Valley, CA 95949-9058 2007-05-01
1104047588 Jeanie Lyn Ibbotson Residential Treatment Facility, Emotionally Disturbed Children 11855 Slow Poke Ln, Grass Valley, CA 95945-8417 2007-05-01
Find all providers in GRASS VALLEY

Competitor

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City GRASS VALLEY
Zip Code 95945

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Dataset Information

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.

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