NPIMap

Organization Active NPI

Crestwood Behavioral Health, Inc.

Doing business as Bridge Program - Fresno

  • Mental Illness Community Based Residential Treatment Facility
  • Fresno, CA
National Provider Identifier
1093892663
Registry record updated Nov 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
CRESTWOOD BEHAVIORAL HEALTH, INC.
Doing business as
Bridge Program - Fresno
Practice address
153 N U St
Fresno, CA 93701-2438
Phone
(559) 445-9094
Fax
(559) 445-9083
NPI assigned
Nov 1, 2006
Last updated
Nov 30, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2023

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

Authorized official

Name
Michelle Smith
Title
Executive Director Ar and Reimb.
Phone
(209) 955-2364

Specialties & licenses 1

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

Addresses

Primary practice location

153 N U St
Fresno, CA 93701-2438

Mailing address

7590 Shoreline Dr
Stockton, CA 95219-5455
Phone (209) 955-2328

Other names 1

  • BRIDGE PROGRAM - FRESNO Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Crestwood Behavioral Health Inc71 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 19

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 19

Locations

153 N U St
Fresno, CA 93701
Phone (559) 445-9094

Practitioners & affiliated clinicians

Practitioners 30

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 30

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701302400000",
    "number": "1093892663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7590 SHORELINE DR",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952195455",
            "telephone_number": "209-955-2328",
            "fax_number": "209-952-5314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 N U ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937012438",
            "telephone_number": "559-445-9094",
            "fax_number": "559-445-9083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESTWOOD BEHAVIORAL HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR AR AND REIMB.",
        "authorized_official_telephone_number": "209-955-2364"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BRIDGE PROGRAM - FRESNO",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BRIDGE PROGRAM - FRESNO",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2023; 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.