NPIMap

Organization Active NPI

Canyon Acres Children and Family Services

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Anaheim, CA
National Provider Identifier
1104023183
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
Legal business name
CANYON ACRES CHILDREN AND FAMILY SERVICES
Practice address
160 S Fairmont Blvd
Anaheim, CA 92808-1336
Phone
(714) 998-3272
NPI assigned
Jul 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Clete Menke
Title
Executive Director
Phone
(714) 998-3272

Specialties & licenses 1

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

Addresses

Primary practice location

160 S Fairmont Blvd
Anaheim, CA 92808-1336

Mailing address

160 S Fairmont Blvd
Anaheim, CA 92808-1336

Other names 1

  • Canyon Acres Other name

National Provider Directory

National Provider Directory
Tax ID family
Canyon Acres Children and Family Services5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

160 S Fairmont Blvd
Anaheim, CA 92808
Phone (714) 998-3272

NPI Registry JSON

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

{
    "created_epoch": "1183334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104023183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 S FAIRMONT BLVD",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928081336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 S FAIRMONT BLVD",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928081336",
            "telephone_number": "714-998-3272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANYON ACRES CHILDREN AND FAMILY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MENKE",
        "authorized_official_first_name": "CLETE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "714-998-3272"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Canyon Acres",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.