Providence Respite Inc

Primary specialty

Child Intellectual and/or Developmental Disabilities Respite CareTaxonomy code 385HR2060X

Legal business name

PROVIDENCE RESPITE INC

Practice address

400 N Mountain Ave Ste 123C
Upland, CA 91786-5176

Phone

(909) 813-3783

NPI assigned

Oct 25, 2021

Organization subpart

No

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

Authorized official

Name

Beatriz Gabrielle

Title

Owner

Phone

(909) 813-3793

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1635120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635120000000",
    "number": "1194489237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N MOUNTAIN AVE STE 123C",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917865176",
            "telephone_number": "909-813-3783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N MOUNTAIN AVE STE 123C",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917865176",
            "telephone_number": "909-813-3783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE RESPITE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-25",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-25",
        "status": "A",
        "authorized_official_last_name": "GABRIELLE",
        "authorized_official_first_name": "BEATRIZ",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-813-3793"
    },
    "taxonomies": [
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Prosperity Senior Living, LLC
• Prosperous Medical Billing and Consulting, LLC
• Britni Lynn, Nicole Proulx
• Robert E. Proulx, MFT
• Julia Mari Provens
• Provision Care Hospice Inc
• Provision Healthcare Services
• Aimee Provost
• Ashley D. Prueitt, PSYD
• Psalm71:9 LLC

• Child Intellectual and/or Developmental Disabilities Respite Care in Upland, CA
• Providers in Upland, CA by specialty
• Child Intellectual and/or Developmental Disabilities Respite Care in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.