NPIMap

Organization Active NPI

Willow Glen Care Center

  • Mental Illness Community Based Residential Treatment Facility
  • Chico, CA
National Provider Identifier
1093156317
Registry record updated Sep 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
045002488 Issued in CA
Legal business name
WILLOW GLEN CARE CENTER
Practice address
2753 White Ave
Chico, CA 95973-0496
Phone
(530) 413-9252
Fax
(530) 413-9476
NPI assigned
Jul 15, 2013
Organization subpart
Yes
Parent organization
WILLOW GLEN CARE CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 30, 2020

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

Authorized official

Name
Dr. John Riley, M.D.
Title
Medical Director
Phone
(530) 751-9902

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X 045002488 CA Primary

Addresses

Primary practice location

2753 White Ave
Chico, CA 95973-0496

Mailing address

1547 Plumas CT
Yuba City, CA 95991-2960
Phone (530) 751-9900

Other names 1

  • Trinity Pines Other name

National Provider Directory

National Provider Directory
Tax ID family
Willow Glen Care Center9 organizations share this tax ID, including this one
Part of
Willow Glen Care Center

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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": "1373846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601424000000",
    "number": "1093156317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1547 PLUMAS CT",
            "city": "YUBA CITY",
            "state": "CA",
            "postal_code": "959912960",
            "telephone_number": "530-751-9900",
            "fax_number": "530-751-9915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2753 WHITE AVE",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959730496",
            "telephone_number": "530-413-9252",
            "fax_number": "530-413-9476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW GLEN CARE CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WILLOW GLEN CARE CENTER",
        "enumeration_date": "2013-07-15",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A",
        "authorized_official_last_name": "RILEY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "530-751-9902",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "CA",
            "license": "045002488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Trinity Pines",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Chico, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2020; 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.