West Covina Group Corporation

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

360911241 Issued in CA

Legal business name

WEST COVINA GROUP CORPORATION

Practice address

1274 Center Court Dr, #208
Covina, CA 91724

Phone

(626) 221-6406

Fax

(626) 859-4087

NPI assigned

Sep 1, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Hardip Gill, ENGINEER

Title

Executive Director

Phone

(626) 221-6406

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472688000000",
    "number": "1386191963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1274 CENTER COURT DR, #208",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "91724",
            "telephone_number": "626-221-6406",
            "fax_number": "626-859-4087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1274 CENTER COURT DR, #208",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "91724",
            "telephone_number": "626-221-6406",
            "fax_number": "626-859-4087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST COVINA GROUP CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-01",
        "last_updated": "2016-09-01",
        "status": "A",
        "authorized_official_last_name": "GILL",
        "authorized_official_first_name": "HARDIP",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "626-221-6406",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ENGINEER"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "CA",
            "license": "360911241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Job Wells
• Victoria Wen
• Brelle Leianna Wenze
• Zoey Kelis Werts
• West Covina Foster Family Agency
• West Covina Plan Ipa Inc., a Medical Group
• West Covina Plan Ipa, Inc., a Medical Group
• Yasmeen Westbrook Preito
• Western Dental Services, Inc.
• Westlake Villa Hospice, Inc.

• Emotionally Disturbed Childrens' Residential Treatment Facility in Covina, CA
• Providers in Covina, CA by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 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.