NPIMap

Organization Active NPI

Mary'S Shelter

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Santa Ana, CA
National Provider Identifier
1114503760
Registry record updated Mar 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
Legal business name
MARY'S SHELTER
Practice address
18221 E 17TH St
Santa Ana, CA 92705-2676
Phone
(714) 730-0930
NPI assigned
Mar 23, 2021
Organization subpart
Yes
Parent organization
MARY'S SHELTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 23, 2021

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

Authorized official

Name
Kelli Cayley Strickland, LCSW
Title
Lead Social Worker
Phone
(714) 730-0930

Specialties & licenses 1

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

Addresses

Primary practice location

18221 E 17TH St
Santa Ana, CA 92705-2676

Mailing address

18221 E 17TH St
Santa Ana, CA 92705-2676
Phone (714) 730-0930

Other names 1

  • CYS Mary's Path House 1 Other name

National Provider Directory

National Provider Directory
Tax ID family
Mary'S Shelter5 organizations share this tax ID, including this one
Part of
Mary'S Shelter

Other organizations with this tax ID 4

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1616457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616457600000",
    "number": "1114503760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18221 E 17TH ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927052676",
            "telephone_number": "714-730-0930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18221 E 17TH ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927052676",
            "telephone_number": "714-730-0930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY'S SHELTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARY'S SHELTER",
        "enumeration_date": "2021-03-23",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-01",
        "status": "A",
        "authorized_official_last_name": "STRICKLAND",
        "authorized_official_first_name": "KELLI",
        "authorized_official_middle_name": "CAYLEY",
        "authorized_official_title_or_position": "LEAD SOCIAL WORKER",
        "authorized_official_telephone_number": "714-730-0930",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CYS Mary's Path House 1",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; 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.