NPIMap

Organization Active NPI

Runnymede Group Home

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Van Nuys, CA
National Provider Identifier
1346791100
Registry record updated Oct 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
191221595 Issued in CA
Legal business name
RUNNYMEDE GROUP HOME
Practice address
15352 Runnymede
Van Nuys, CA 91405
Phone
(818) 988-9042
Fax
(818) 988-9042
NPI assigned
Oct 17, 2016
Organization subpart
Yes
Parent organization
CHILDREN'S HOMES OF SOUTHERN CALIFORNIAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 17, 2016

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

Authorized official

Name
Mr. Jorge C Marquez
Title
Executive Director
Phone
(818) 592-2960

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X 191221595 CA Primary

Addresses

Primary practice location

15352 Runnymede
Van Nuys, CA 91405

Mailing address

22455 Victory Blvd
West Hills, CA 91307
Phone (818) 592-2960

National Provider Directory

National Provider Directory
Tax ID family
Shoup Group Home7 organizations share this tax ID, including this one
Part of
Shoup Group Home

Other organizations with this tax ID 6

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": "1476662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476662400000",
    "number": "1346791100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22455 VICTORY BLVD",
            "city": "WEST HILLS",
            "state": "CA",
            "postal_code": "91307",
            "telephone_number": "818-592-2960",
            "fax_number": "818-592-2961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15352 RUNNYMEDE",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "91405",
            "telephone_number": "818-988-9042",
            "fax_number": "818-988-9042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUNNYMEDE GROUP HOME",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHILDREN'S HOMES OF SOUTHERN CALIFORNIA",
        "enumeration_date": "2016-10-17",
        "last_updated": "2016-10-17",
        "status": "A",
        "authorized_official_last_name": "MARQUEZ",
        "authorized_official_first_name": "JORGE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "818-592-2960",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "CA",
            "license": "191221595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2016; 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.