CRESTWOOD BEHAVIORAL HEALTH, INC. (NPI# 1730128174) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730128174 |
| Entity Type | Organization |
| Organization Name | CRESTWOOD BEHAVIORAL HEALTH, INC. |
| Other Organization Name | CRESTWOOD MANOR |
| Practice Address |
1130 Monaco Ct Stockton CA 95207-6704 |
| Mailing Address |
7590 Shoreline Dr Stockton CA 95219-5455 |
| Practice Telephone | 2094782060 |
| Practice Fax Number | 2094783175 |
| Mailing Telephone | 2099552328 |
| Mailing Fax Number | 2099525314 |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2015-05-19 |
| 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 | 314000000X | Skilled Nursing Facility | CA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | ZZR55075H | 05 |
| Other Name | Type Code |
|---|---|
| CRESTWOOD MANOR | 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 |
1130 MONACO CT |
| City | STOCKTON |
| State | CA |
| Zip Code | 95207-6704 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841261054 | John Fong | Psychiatry & Neurology | 1130 Monaco Ct, Stockton, CA 95207 | 2006-01-27 |
| 1346373875 | Stanislaus County | Community/Behavioral Health | 1130 Monaco Ct, Stockton, CA 95207-6704 | 2007-03-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669004438 | Dr. Jeffrey A Saladin, Dental Corporation | Dentist | 1002 Robinhood Drive, Stockton, CA 95207 | 2020-02-10 |
| 1811533110 | Tanya V Jones | Dental Hygienist | Community Medical Centers, 83 W. March Ln., Stockton, CA 95207 | 2019-11-21 |
| 1053966358 | Ingrid Marcela Saavedra | Behavioral Analyst | 1545 Saint Marks Plaza Ste 9, Stockton, CA 95207 | 2019-08-05 |
| 1497218861 | Turning Point Community Programs | Community/Behavioral Health | 1803 W March Ln Ste C-d, Stockton, CA 95207 | 2019-04-11 |
| 1427510627 | Stockton Sleep Center Inc | Physiological Laboratory | 1545 Saint Marks Plaza, Suite 2, Stockton, CA 95207 | 2019-04-05 |
| 1518436229 | Nicolas Anthony Overby | Occupational Therapist | Windsor Elmhaven Care Cente 6940 Pacific Ave, Stockton, CA 95207 | 2018-11-26 |
| 1912475724 | Ashley Johnson | Behavior Technician | 87 W. March Ln. Suite 6, Stockton, CA 95207 | 2018-11-09 |
| 1124596085 | Korie Cottrell | Behavior Technician | 87 W. March Ln., Suite 6, Stockton, CA 95207 | 2018-11-08 |
| 1760979645 | Maria Esther Rodriguez | Counselor | 2425 W March Ln., Stockton, CA 95207 | 2018-04-17 |
| 1902301161 | Lashray Elliott | Behavior Technician | 2291 W. Mach Lane, Ste C101, Stockton, CA 95207 | 2018-03-28 |
| Find all providers in zip 95207 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316330152 | Waverly Place of Stockton, LLC | Skilled Nursing Facility | 501 E Front Avenue, Stockton, IL 61085 | 2015-03-17 |
| 1932507431 | Sandra Rae Divine | Skilled Nursing Facility | 1015 Lancaster Dr, Stockton, MO 65785-8360 | 2014-12-15 |
| 1114323136 | Good Samaritan Care Provider LLC | Skilled Nursing Facility | 10740 Oakwilde Ave, Stockton, CA 95212-9249 | 2014-11-19 |
| 1801938816 | Covenant Care California, LLC | Skilled Nursing Facility | 9289 Branstetter Place, Stockton, CA 95209-1700 | 2007-02-13 |
| 1730269184 | O'connor Woods Housing Corp | Skilled Nursing Facility | 3110 Wagner Heights Rd, Stockton, CA 95209-4848 | 2006-10-17 |
| 1891700464 | Kindred Nursing Centers West, LLC | Skilled Nursing Facility | 1517 E Knickerbocker Dr, Stockton, CA 95210-3119 | 2006-07-30 |
| 1548283542 | Stockton Edison Healthcare Corporation | Skilled Nursing Facility | 1630 N. Edison St., Stockton, CA 95204 | 2006-07-25 |
| 1871512046 | Helios Healthcare, LLC | Skilled Nursing Facility | 442 E Hampton St, Stockton, CA 95204-5519 | 2006-07-19 |
| 1922027002 | Helios Healthcare, LLC | Skilled Nursing Facility | 6940 Pacific Ave, Stockton, CA 95207-2602 | 2006-07-19 |
| 1487601704 | Sunbridge Stockton Rehabilitation Center LLC | Skilled Nursing Facility | 9107 Davis Rd, Stockton, CA 95209-1807 | 2006-05-30 |
| Find all providers in STOCKTON | ||||
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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.