CHALLENGER YOUTH MEMORIAL CENTER (NPI# 1881757805) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881757805 |
| Entity Type | Organization |
| Organization Name | CHALLENGER YOUTH MEMORIAL CENTER |
| Practice Address |
5300 W Avenue I Lancaster CA 93536-8312 |
| Mailing Address |
40601 Royal Lytham Ct Palmdale CA 93551-5608 |
| Practice Telephone | 6619404120 |
| Mailing Telephone | 6619476463 |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. JANICE AUSTIN-TAYLOR (MENTAL HEALTH CLINICIAN) |
| Authorized Official Telephone | 6619404120 |
| Authorized Official Credential | MFT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | MFT36808 | CA | Residential Treatment Facilities |
| Street Address |
5300 W AVENUE I |
| City | LANCASTER |
| State | CA |
| Zip Code | 93536-8312 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306850169 | Los Angeles County Department of Mental Health | Clinic/Center | 5300 W Avenue I, Lancaster, CA 93536-8312 | 2006-07-28 |
| 1144698564 | California State University Northridge | Community Based Residential Treatment Facility, Mental Illness | 5300 W Avenue I, Lancaster, CA 93536-8312 | 2015-09-02 |
| 1114320611 | Antwain Wilson | Counselor | 5300 W Avenue I, Lancaster, CA 93536-8312 | 2014-09-29 |
| 1437497575 | Child and Family Center | Community/Behavioral Health | 5300 W Avenue I, Lancaster, CA 93536 | 2013-01-24 |
| 1952647604 | Linet Khodabakhsh | Social Worker | 5300 W Avenue I, Lancaster, CA 93536-8312 | 2012-12-28 |
| 1437415585 | Sibichan Varghese | Social Worker | 5300 W Avenue I, Lancaster, CA 93536-8312 | 2012-04-03 |
| 1881965077 | Sheretta Deion Thomas | Counselor | 5300 W Avenue I, Lancaster, CA 93536-8312 | 2012-01-19 |
| 1427353374 | Jennifer Boehmke | Marriage & Family Therapist | 5300 W Avenue I, Lancaster, CA 93536-8312 | 2011-01-24 |
| 1982908505 | Autumn Nicole Scott | Counselor | 5300 W Avenue I, Lancaster, CA 93536-8312 | 2010-12-23 |
| 1346542156 | Natalie Madriz | Social Worker | 5300 W Avenue I, Lancaster, CA 93536-8312 | 2010-11-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053921353 | Icgrit, LLC | Durable Medical Equipment & Medical Supplies | 42304 Columbia Court, Lancaster, CA 93536 | 2020-08-03 |
| 1346891827 | Rebecca Rozenberg | Nurse Practitioner | 7060 Hemlock Avenue, Lancaster, CA 93536 | 2019-09-25 |
| 1972078053 | Cherokee Hill | Social Worker | 42055 50th St. W, Quartz Hiu, CA 93536 | 2018-10-04 |
| 1932600954 | Alderbrook, Inc. | Skilled Nursing Facility | 2540 W Avenue K, Lancaster, CA 93536 | 2018-02-25 |
| 1679095244 | Maria Celeste Montebello | Registered Nurse | 335 E. Avenue I, Lancaster, CA 93536 | 2017-07-14 |
| 1073035994 | Letecia Bell | Registered Nurse | 6637 Lime Road, Lancaster, CA 93536 | 2017-07-12 |
| 1366890089 | Omolola Omishore | Physical Therapist | 43415 Hampton St, Quartz Hill, CA 93536 | 2016-06-03 |
| 1073976528 | May Chong Finley | Registered Nurse | 7027 W Avenue L6, Lancaster, CA 93536 | 2016-04-01 |
| 1043689904 | Til Lp | Skilled Nursing Facility | 2639 West Ave K4, Lancaster, CA 93536 | 2015-09-22 |
| 1497140222 | Oak Fence Senior Living, LLC | Skilled Nursing Facility | 6067 West Oak Fence Lane, Lancaster, CA 93536 | 2015-03-30 |
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| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639554686 | Robicheaux Haven | Community Based Residential Treatment Facility, Mental Illness | 2605 Princeton Dr, Lancaster, TX 75134-2445 | 2015-07-20 |
| 1972872836 | Metrocare | Community Based Residential Treatment Facility, Mental Illness | 200 Greene Rd., Lancaster, TX 75146-1004 | 2011-12-22 |
| 1144698564 | California State University Northridge | Community Based Residential Treatment Facility, Mental Illness | 5300 W Avenue I, Lancaster, CA 93536-8312 | 2015-09-02 |
| 1538237946 | Challenger | Community Based Residential Treatment Facility, Mental Illness | 5300 W Avenue I, Lancaster, CA 93536-8312 | 2006-12-01 |
| 1427125574 | Challenger | Community Based Residential Treatment Facility, Mental Illness | 5300 W Avenue I, Lancaster, CA 93536-8312 | 2006-11-30 |
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|---|---|---|---|---|
| 1215538244 | Evolve Growth Initiatives LLC | Community Based Residential Treatment Facility, Mental Illness | 10525 Fuerte Dr, La Mesa, CA 91941-4350 | 2020-11-05 |
| 1154922458 | A Better Life Recovery LLC | Community Based Residential Treatment Facility, Mental Illness | 24171 Grayston Dr, Lake Forest, CA 92630-3839 | 2020-11-03 |
| 1003417684 | A Better Life Recovery LLC | Community Based Residential Treatment Facility, Mental Illness | 1155 Hoover St, Carlsbad, CA 92008-4230 | 2020-11-02 |
| 1497356075 | A Better Life Recovery LLC | Community Based Residential Treatment Facility, Mental Illness | 405 N Tremont St, Oceanside, CA 92054-2535 | 2020-11-02 |
| 1467053041 | A Better Life Recovery LLC | Community Based Residential Treatment Facility, Mental Illness | 6477 Goldenbush Dr, Carlsbad, CA 92011-4203 | 2020-11-02 |
| 1366043937 | A Better Life Recovery LLC | Community Based Residential Treatment Facility, Mental Illness | 26065 Waterwheel Pl, Laguna Hills, CA 92653-6114 | 2020-11-02 |
| 1730780313 | Orchid Court, Inc. | Community Based Residential Treatment Facility, Mental Illness | 307 S Arrowhead Avenue, San Bernardino, CA 92408-1325 | 2020-11-02 |
| 1477151199 | Inspiring Pathways, Inc. | Community Based Residential Treatment Facility, Mental Illness | 1798 Bryman St, Hanford, CA 93230-7144 | 2020-10-14 |
| 1356949226 | Wings Recovery Center, Inc. | Community Based Residential Treatment Facility, Mental Illness | 3134 Morningside Dr, Oceanside, CA 92056-4401 | 2020-10-13 |
| 1326645904 | New Passages Group Home, Inc. | Community Based Residential Treatment Facility, Mental Illness | 5675 E Ashlan Ave, Fresno, CA 93727-7220 | 2020-10-06 |
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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.