Puente de Vida, Inc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

PUENTE DE VIDA, INC

Doing business as

Eating Disorder Center of Fresno

Practice address

723 W Shaw Ave
Fresno, CA 93704-2302

Phone

(559) 224-8408

NPI assigned

May 2, 2013

Organization subpart

No

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

Authorized official

Name

Stephen E Schaefer, LCSW

Title

President

Phone

(559) 224-8408

Specialties & licenses 1

Addresses

Other names 1

• Eating Disorder Center of Fresno Doing business as

Tax ID family

Eating Disorder Center of Fresno3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Puente de Vida

  • Psychiatric Residential Treatment Facility
  • La Jolla, CA
  • NPI 1881728954
  NPD tax ID
• Puente de Vida, Inc

  • Psychiatric Residential Treatment Facility
  • San Diego, CA
  • NPI 1265737829
  NPD tax ID

Locations

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

{
    "created_epoch": "1367452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367452800000",
    "number": "1194160275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 86020",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921386020",
            "telephone_number": "858-452-3915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "723 W SHAW AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937042302",
            "telephone_number": "559-224-8408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUENTE DE VIDA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-02",
        "last_updated": "2013-05-02",
        "status": "A",
        "authorized_official_last_name": "SCHAEFER",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "559-224-8408",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eating Disorder Center of Fresno",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Psycorp Solutions, Inc.
• Grzegorz Sebastian Puchala, DO
• Neila Madorna Puchi Ruble
• Sintia M Puckett
• Teagan Iona Puckett
• Gabrielle Lileiann Puente
• Ricardo Arturo Puente
• Simon Puente III, LCSW
• Crystin Puentes
• Diego Puentes, DO

• Community/Behavioral Health Agency in Fresno, CA
• Providers in Fresno, CA by specialty
• Community/Behavioral Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2013; 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.