NPIMap

Organization Active NPI

Diakonia, Inc.

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Rialto, CA
National Provider Identifier
1104522119
Registry record updated Feb 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
Legal business name
DIAKONIA, INC.
Practice address
1264 S Lilac Ave
Rialto, CA 92376-7443
Phone
(909) 874-6544
NPI assigned
Feb 1, 2023
Organization subpart
Yes
Parent organization
-As reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 1, 2023

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

Authorized official

Name
Tiffany Merritt
Title
Program Director
Phone
(909) 278-4312

Specialties & licenses 1

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

Addresses

Primary practice location

1264 S Lilac Ave
Rialto, CA 92376-7443

Mailing address

1264 S Lilac Ave
Rialto, CA 92376-7443
Phone (909) 874-6544

Other names 1

  • Maywright Boys Home Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Diakonia Inc4 organizations share this tax ID, including this one
Part of
Diakonia Inc

Other organizations with this tax ID 3

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": "1675209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675209600000",
    "number": "1104522119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1264 S LILAC AVE",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923767443",
            "telephone_number": "909-874-6544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1264 S LILAC AVE",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923767443",
            "telephone_number": "909-874-6544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAKONIA, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "-",
        "enumeration_date": "2023-02-01",
        "last_updated": "2023-02-01",
        "certification_date": "2023-01-24",
        "status": "A",
        "authorized_official_last_name": "MERRITT",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "909-278-4312"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maywright Boys Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rialto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 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.