Varsity Team, Incorporated
Organization Active NPI Emotionally Disturbed Childrens' Residential Treatment Facility · Brawley, CA
NPI 1245814151 · NPPES record last updated May 6, 2021
Key facts
- NPI
- 1245814151
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X
- Legal business name
- VARSITY TEAM, INCORPORATED
- Practice address
- 602 S 18TH St
Brawley, CA 92227-2859 - Phone
- (760) 623-7131
- Fax
- (619) 362-9532
- NPI assigned
- May 6, 2021
- Organization subpart
- No
Authorized official
- Name
- Drew Dahlstedt
- Title
- Cfo/Coo
- Phone
- (619) 694-6809
Corporate family (same tax ID) 3
Practitioners 8
National Provider Directory
- Tax ID family
- Varsity Team 1
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor |
101YM0800X | |||
| Community/Behavioral Health Agency | 251S00000X | |||
| Adolescent and Children Mental Health Clinic/Center | 261QM0855X | |||
| Emotionally Disturbed Childrens' Residential Treatment Facility | 322D00000X | Yes | ||
| Psychiatric Residential Treatment Facility | 323P00000X | |||
| Children's Substance Abuse Rehabilitation Facility | 3245S0500X |
Addresses
Primary practice location
602 S 18TH St
Brawley, CA 92227-2859
Mailing address
PO Box 26633
San Diego, CA 92196-0633
Phone (619) 694-6809
Other practice location 1
1305 S La Brucherie Rd
El Centro, CA 92243-9518
Phone (760) 339-4992
Other practice location 2
8745 Bennington St
San Diego, CA 92126-3221
Phone (858) 860-5332
Other practice location 3
3027 Fleming Dr
San Diego, CA 92139-3714
Phone (619) 512-1552
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- Juan C Velazquez
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- Luis Enrique Verduzco
All providers in Brawley, CA · Emotionally Disturbed Childrens' Residential Treatment Facility in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 6, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.