NPIMap

Organization Active NPI

Tessie Cleveland Community Services Corporation

  • Adolescent and Children Mental Health Clinic/Center
  • Los Angeles, CA
National Provider Identifier
1194850842
Registry record updated Oct 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
TESSIE CLEVELAND COMMUNITY SERVICES CORPORATION
Practice address
8019 S. Compton Avenue
Los Angeles, CA 90001-3409
Phone
(323) 586-7333
NPI assigned
Feb 22, 2007
Last updated
Oct 31, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2018

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

Authorized official

Name
Mrs. Carolyn Chadwick
Title
Chief Operating Officer
Phone
(323) 586-7333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X NU Primary

Addresses

Primary practice location

8019 S. Compton Avenue
Los Angeles, CA 90001-3409

Mailing address

8019 S. Compton Avenue
Los Angeles, CA 90001-3409
Phone (323) 586-7333

Other identifiers 1

IdentifierTypeStateIssuer
7641MedicaidCA

Other names 1

  • Tessie Cleveland Community Services Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111025000673 CA Part B Supplier - Clinic/Group Practice 6901079631 Receives reassigned benefits from 9 practitioners
Practice locations: Los Angeles, CA

National Provider Directory

National Provider Directory
Tax ID family
Tessie Cleveland Community7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540944000000",
    "number": "1194850842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8019 S. COMPTON AVENUE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900013409",
            "telephone_number": "323-586-7333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8019 S. COMPTON AVENUE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900013409",
            "telephone_number": "323-586-7333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TESSIE CLEVELAND COMMUNITY SERVICES CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2018-10-31",
        "status": "A",
        "authorized_official_last_name": "CHADWICK",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "323-586-7333",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7641",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tessie Cleveland Community Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.