NPIMap

Organization Active NPI

Kesewa Safe Haven

Doing business as N/a

  • Community/Behavioral Health Agency
  • Rialto, CA
National Provider Identifier
1346932555
Registry record updated May 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
KESEWA SAFE HAVEN
Doing business as
N/a
Practice address
229 S Riverside Ave
Rialto, CA 92376-6467
Phone
(190) 999-7586
NPI assigned
May 24, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2023

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

Authorized official

Name
Mr. Nana A Bamfo, LMFTNPI 1023403847
Title
Licensed Marriage Therapist
Phone
(909) 997-5863

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Public Health or Welfare Agency 251K00000X
Community/Behavioral Health Agency 251S00000X Primary
PACE Provider Organization 251T00000X
Early Intervention Provider Agency 252Y00000X
Clinic/Center 261Q00000X

Addresses

Primary practice location

229 S Riverside Ave
Rialto, CA 92376-6467

Mailing address

520 W Mesa Ave
Rialto, CA 92376-3285
Phone (909) 997-5863

Other names 1

  • N/a Doing business as

National Provider Directory

National Provider Directory

Locations

229 S Riverside Ave
Rialto, CA 92376

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1684886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684886400000",
    "number": "1346932555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 W MESA AVE",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923763285",
            "telephone_number": "909-997-5863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 S RIVERSIDE AVE",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923766467",
            "telephone_number": "190-999-7586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KESEWA SAFE HAVEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-24",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A",
        "authorized_official_last_name": "BAMFO",
        "authorized_official_first_name": "NANA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "LICENSED MARRIAGE THERAPIST",
        "authorized_official_telephone_number": "909-997-5863",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251T00000X",
            "taxonomy_group": "",
            "desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "N/a",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rialto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 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.