NPIMap

Organization Active NPI

Salem Christian Homes, Inc

Doing business as Bonnie Brae Home

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Ontario, CA
National Provider Identifier
1114183589
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
License
240000821 Issued in CA
Legal business name
SALEM CHRISTIAN HOMES, INC
Doing business as
Bonnie Brae Home
Practice address
226 W Bonnie Brae CT
Ontario, CA 91762-1617
Phone
(909) 984-4524
Fax
(909) 930-9880
NPI assigned
Aug 5, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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

Authorized official

Name
Mrs. Shelly Dawson
Title
Qa Director
Phone
(714) 321-8860

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X 240000821 CA Primary

Addresses

Primary practice location

226 W Bonnie Brae CT
Ontario, CA 91762-1617

Mailing address

6921 Edison Ave
Chino, CA 91710-9057
Phone (909) 947-3761

Other names 1

  • BONNIE BRAE HOME Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1114183589. Details of each certification follow.

  • CCN 55G386 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 55G386

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
Bonnie Brae Home
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Aug 1, 2001
Last certification
May 13, 2025
Beds
6
Ownership / control type
Private (non-profit)
Facility address
226 W Bonnie Brae Ct
Ontario, CA 91762

National Provider Directory

National Provider Directory
Tax ID family
Salem Christian Homes Inc9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

NPI Registry JSON

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

{
    "created_epoch": "1217894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718150400000",
    "number": "1114183589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6921 EDISON AVE",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917109057",
            "telephone_number": "909-947-3761",
            "fax_number": "909-673-0048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 W BONNIE BRAE CT",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917621617",
            "telephone_number": "909-984-4524",
            "fax_number": "909-930-9880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALEM CHRISTIAN HOMES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-05",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A",
        "authorized_official_last_name": "DAWSON",
        "authorized_official_first_name": "SHELLY",
        "authorized_official_title_or_position": "QA DIRECTOR",
        "authorized_official_telephone_number": "714-321-8860",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "CA",
            "license": "240000821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BONNIE BRAE HOME",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ontario, CA

Sources for this page

Verify at the official NPI Registry.