NPIMap

Organization Active NPI

Chamberlain's Youth Services

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Hollister, CA
National Provider Identifier
1083010409
Registry record updated Mar 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
355201170 Issued in CA
Legal business name
CHAMBERLAIN'S YOUTH SERVICES
Practice address
1850 San Benito St
Hollister, CA 95023-4899
Phone
(831) 636-2121
Fax
(831) 636-5296
NPI assigned
Nov 12, 2014
Last updated
Mar 21, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2019

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

Authorized official

Name
Melanie Marie Davis, LCSW
Title
Dir. Mental Health Services
Phone
(831) 636-2121

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X 355201170 CA Primary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X

Addresses

Primary practice location

1850 San Benito St
Hollister, CA 95023-4899

Mailing address

1850 San Benito St
Hollister, CA 95023-4899
Phone (831) 636-2121

National Provider Directory

National Provider Directory

Locations

1850 Cienega Rd
Hollister, CA 95023
Phone (831) 636-2121

Practitioners & affiliated clinicians

Practitioners 71

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 71

NPI Registry JSON

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

{
    "created_epoch": "1415750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553126400000",
    "number": "1083010409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 SAN BENITO ST",
            "city": "HOLLISTER",
            "state": "CA",
            "postal_code": "950234899",
            "telephone_number": "831-636-2121",
            "fax_number": "831-636-5296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 SAN BENITO ST",
            "city": "HOLLISTER",
            "state": "CA",
            "postal_code": "950234899",
            "telephone_number": "831-636-2121",
            "fax_number": "831-636-5296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAMBERLAIN'S YOUTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-12",
        "last_updated": "2019-03-21",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "MELANIE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "DIR. MENTAL HEALTH SERVICES",
        "authorized_official_telephone_number": "831-636-2121",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "CA",
            "license": "355201170",
            "primary": true
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollister, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2019; 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.