NPIMap

Organization Active NPI

Crestwood Behavioral Health, Inc.

Doing business as Crestwood Youth Enhanced Short-Term Residential Therapeutic Program

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • San Luis Obispo, CA
National Provider Identifier
1407780471
Registry record updated Jun 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
Legal business name
CRESTWOOD BEHAVIORAL HEALTH, INC.
Doing business as
Crestwood Youth Enhanced Short-Term Residential Therapeutic Program
Practice address
2180 Johnson Ave
San Luis Obispo, CA 93401-4558
Phone
(209) 955-2316
NPI assigned
Jun 12, 2026
Last updated
Jun 12, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2026

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

Authorized official

Name
Michelle Smith
Title
Executive Director Reimbursement
Phone
(209) 955-2364

Specialties & licenses 1

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

Addresses

Primary practice location

2180 Johnson Ave
San Luis Obispo, CA 93401-4558

Mailing address

7590 Shoreline Dr
Stockton, CA 95219-5455
Phone (209) 955-2316

Other names 1

  • Crestwood Youth Enhanced Short-Term Residential Therapeutic Program Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Crestwood PHF Sacramento71 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

2180 Johnson Ave
Sn Luis Obisp, CA 93401
Phone (805) 781-4275

NPI Registry JSON

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

{
    "created_epoch": "1781222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781222400000",
    "number": "1407780471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7590 SHORELINE DR",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952195455",
            "telephone_number": "209-955-2316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2180 JOHNSON AVE",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934014558",
            "telephone_number": "209-955-2316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESTWOOD BEHAVIORAL HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-06-12",
        "last_updated": "2026-06-12",
        "certification_date": "2026-06-12",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR REIMBURSEMENT",
        "authorized_official_telephone_number": "209-955-2364"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crestwood Youth Enhanced Short-Term Residential Therapeutic Program",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Luis Obispo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2026; 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.