ORCHID COURT, INC.


Address: 307 S Arrowhead Avenue, San Bernardino, CA 92408-1325
Phone: 9098843044

ORCHID COURT, INC. (NPI# 1730780313) 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) 1730780313
Entity Type Organization
Organization Name ORCHID COURT, INC.
Practice Address 307 S Arrowhead Avenue
San Bernardino
CA 92408-1325
Practice Telephone 9098843044
Practice Fax Number 9098843044
Mailing Telephone 9098843044
Mailing Fax Number 9098843044
Enumeration Date 2020-11-02
Last Update Date 2020-11-02
Authorized Official Name MR. CLODOVEO R. GOSUICO III (ADMINISTRATOR)
Authorized Official Telephone 9098843044
Is Organization Subpart Y
Parent Organization Name ORCHID COURT, INC.

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 320800000X Community Based Residential Treatment Facility, Mental Illness Residential Treatment Facilities

Other Provider/Organization Names

Other Name Type Code
Orchid Court, Inc Doing Business As Name - Organization

Office Location

Street Address 307 S ARROWHEAD AVENUE
City SAN BERNARDINO
State CA
Zip Code 92408-1325

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1548730419 Adriana Alcaraz Behavior Technician 473 E Carnegie, Ste 200, San Bernardino, CA 92408 2018-12-04
1811467889 Xavier J Molina-williams Behavior Technician 476 E Carnegie Drive, Ste 200, San Bernardino, CA 92408 2018-12-03
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Taxonomy Information

Taxonomy Code 320800000X
Grouping Residential Treatment Facilities
Classification Community Based Residential Treatment Facility, Mental Illness

Taxonomy Definition

A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
Notes: [7/1/2003: new]

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NPI Name Taxonomy Address Enumeration
1699299180 Helping Hearts California, LLC Community Based Residential Treatment Facility, Mental Illness 2421 Kern St, San Bernardino, CA 92407-6111 2017-07-27
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1326432527 Valley Star Crt - 'the Stay' Community Based Residential Treatment Facility, Mental Illness 780 E Gilbert St, San Bernardino, CA 92415-1003 2015-03-25
1679905137 Horatius Gittens Community Based Residential Treatment Facility, Mental Illness 1053 N D St, San Bernardino, CA 92410-3521 2013-08-06
1851637151 Valley Star Behavioral Health, Inc. Community Based Residential Treatment Facility, Mental Illness 780 E Gilbert St, San Bernardino, CA 92415-1003 2012-12-14
1306905195 Victor Treatment Centers, Inc. Community Based Residential Treatment Facility, Mental Illness 1053 N D St, San Bernardino, CA 92410-3521 2006-12-07

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Competitor

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City SAN BERNARDINO
Zip Code 92408

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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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