NPIMap

Organization Active NPI

Time for Change Foundation

  • Case Management Agency
  • San Bernardino, CA
National Provider Identifier
1013392901
Registry record updated Jul 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
License
360071AN Issued in CA
Legal business name
TIME FOR CHANGE FOUNDATION
Practice address
1255 E Highland Ave
Suite #211
San Bernardino, CA 92404-6804
Phone
(909) 886-2994
Fax
(909) 886-0218
NPI assigned
Jul 21, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Kim Carter
Title
Executive Director
Phone
(909) 886-2994

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X 360071AN CA Primary

Addresses

Primary practice location

1255 E Highland Ave
Suite #211
San Bernardino, CA 92404-6804

Mailing address

PO Box 25040
San Bernardino, CA 92406-0640
Phone (909) 886-2994

National Provider Directory

National Provider Directory

Locations

1255 E Highland Ave
Ste 211
San Bernardino, CA 92404
Phone (909) 886-2994

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1437436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437436800000",
    "number": "1013392901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25040",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924060640",
            "telephone_number": "909-886-2994",
            "fax_number": "909-886-0218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 E HIGHLAND AVE",
            "address_2": "SUITE #211",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924046804",
            "telephone_number": "909-886-2994",
            "fax_number": "909-886-0218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIME FOR CHANGE FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-21",
        "last_updated": "2015-07-21",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "909-886-2994",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "CA",
            "license": "360071AN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.