NPIMap

Organization Active NPI

Fields Comp. Youth Services Inc.

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • San Bernardino, CA
National Provider Identifier
1295514149
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
Legal business name
FIELDS COMP. YOUTH SERVICES INC.
Practice address
2390 Portola St
San Bernardino, CA 92407-6930
Phone
(909) 376-4148
NPI assigned
Sep 28, 2023
Organization subpart
Yes
Parent organization
FIELDS COMP. YOUTH SERVICES INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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

Authorized official

Name
Arby Enrico Fields
Title
Executive Director
Phone
(909) 322-6980

Specialties & licenses 1

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

Addresses

Primary practice location

2390 Portola St
San Bernardino, CA 92407-6930

Mailing address

8780 19TH St # 196
Alta Loma, CA 91701-4608
Phone (909) 322-6980

Other names 1

  • FIELDS COMPREHENSIVE YOUTH SERVICES INC III Other name

National Provider Directory

National Provider Directory
Tax ID family
Fields Comp Youth Services Inc5 organizations share this tax ID, including this one
Part of
Fields Comp Youth Services Inc

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1695859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695859200000",
    "number": "1295514149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8780 19TH ST # 196",
            "city": "ALTA LOMA",
            "state": "CA",
            "postal_code": "917014608",
            "telephone_number": "909-322-6980",
            "fax_number": "909-466-4815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2390 PORTOLA ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924076930",
            "telephone_number": "909-376-4148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIELDS COMP. YOUTH SERVICES INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FIELDS COMP. YOUTH SERVICES INC.",
        "enumeration_date": "2023-09-28",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A",
        "authorized_official_last_name": "FIELDS",
        "authorized_official_first_name": "ARBY",
        "authorized_official_middle_name": "ENRICO",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "909-322-6980"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FIELDS COMPREHENSIVE YOUTH SERVICES INC III",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2023; 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.