LIFESKILLS DEVELOPMENT (NPI# 1770032534) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770032534 |
| Entity Type | Organization |
| Organization Name | LIFESKILLS DEVELOPMENT |
| Practice Address |
6095 Shepherd Dr San Bernardino CA 92407-2251 |
| Practice Telephone | 9179810503 |
| Mailing Telephone | 9179810503 |
| Enumeration Date | 2016-09-22 |
| Last Update Date | 2016-09-22 |
| Authorized Official Name | DR. RAYMOND ARTHUR BESSE (DEPUTY DIRECTOR) |
| Authorized Official Telephone | 9179810503 |
| Authorized Official Credential | QMHA, M.DIV, PSY |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | Residential Treatment Facilities | ||
| N | 323P00000X | Psychiatric Residential Treatment Facility | Residential Treatment Facilities | ||
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| Street Address |
6095 SHEPHERD DR |
| City | SAN BERNARDINO |
| State | CA |
| Zip Code | 92407-2251 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639789233 | Luis Enrique Macias | Case Manager/Care Coordinator | 26967 Beaumont Ave., Redlands Ca 92373, San Bernardino, CA 92407 | 2020-08-07 |
| 1619526209 | Louise E Curran | Social Worker | 6395 N Azalea Ave, San Bernardino, CA 92407 | 2019-09-06 |
| 1619496049 | Portia Monique Jackson | Licensed Vocational Nurse | 1022 Sunbrook Dr., San Bernardino, CA 92407 | 2017-09-18 |
| 1568988467 | Jon Michael Hensley | Behavior Technician | 1638 Windsor Street, San Bernardino, CA 92407 | 2017-08-22 |
| 1063933349 | Priority Rounds Transport, L.l.c | Non-emergency Medical Transport (VAN) | 18245 Evening Primrose Ln, San Bernardino, CA 92407 | 2017-06-27 |
| 1760927263 | Denkorach Inc | In Home Supportive Care | 1265 Kendall Drive, Unit 1614, San Bernardino, CA 92407 | 2016-12-20 |
| 1558606517 | Pradeep Amin | Pharmacist | 4150 N Sierra Way, San Bernardino, CA 92407 | 2012-12-03 |
| 1811231384 | Lucindy Thomasina Fuller | Rehabilitation Practitioner | 1265 Kendall Dr, San Bernardino, CA 92407 | 2012-11-21 |
| 1578793337 | Shareela Marie Allen | Social Worker | 6791 N. Ofeila Drive, San Bernardino, CA 92407 | 2009-07-15 |
| 1720239304 | Alejandro Paul Holguin | Social Worker | 6076 Norma Ln, San Bernardino, CA 92407 | 2008-10-01 |
| Find all providers in zip 92407 | ||||
| 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 |
|---|---|---|---|---|
| 1508393356 | Harvey House, Inc. | Substance Abuse Rehabilitation Facility | 3512 Nolan St, San Bernardino, CA 92407-6250 | 2017-05-11 |
| 1639621865 | Veterans Alcoholic Rehabilitation Program, Inc. | Substance Abuse Rehabilitation Facility | 349 W 11th St, San Bernardino, CA 92410-3513 | 2016-11-04 |
| 1780041277 | Veterans Alcoholic Rehabilitation Program, Inc. | Substance Abuse Rehabilitation Facility | 384 11th St., San Bernardino, CA 92410-3524 | 2016-01-28 |
| 1508223090 | Veterans Alcoholic Rehabilitation Program, Inc. | Substance Abuse Rehabilitation Facility | 1069 N. 'd' St., San Bernardino, CA 92410-3524 | 2016-01-28 |
| 1821455403 | Veterans Alcoholic Rehabilitation Program, Inc. | Substance Abuse Rehabilitation Facility | 382 11th St., San Bernardino, CA 92410-3524 | 2016-01-27 |
| 1891152476 | Veterans Alcoholic Rehabilitation Program, Inc. | Substance Abuse Rehabilitation Facility | 1107 N. 'd' St., San Bernardino, CA 92410-3524 | 2016-01-27 |
| 1154788743 | Veterans Alcoholic Rehabilitation Program, Inc. | Substance Abuse Rehabilitation Facility | 1139 N. 'd' St., San Bernardino, CA 92410-3524 | 2016-01-27 |
| 1588021182 | Veterans Alcoholic Rehabilitation Program, Inc. | Substance Abuse Rehabilitation Facility | 1149 N. 'd' St., San Bernardino, CA 92410-3524 | 2016-01-27 |
| 1043677636 | Veterans Alcoholic Rehabilitation Program, Inc. | Substance Abuse Rehabilitation Facility | 1087 Stoddard St., San Bernardino, CA 92410-3524 | 2016-01-27 |
| 1699132282 | Veterans Alcoholic Rehabilitation Program, Inc. | Substance Abuse Rehabilitation Facility | 1078 North 'd' St., San Bernardino, CA 92410-3524 | 2016-01-27 |
| Find all providers in SAN BERNARDINO | ||||
| City | SAN BERNARDINO |
| Zip Code | 92407 |
Please comment or provide details below to improve the information on LIFESKILLS DEVELOPMENT.
| 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.