NPIMap

Organization Active NPI

Immaculate Care Centr Inc.

  • Addiction (Substance Use Disorder) Counselor
  • Moreno Valley, CA
National Provider Identifier
1528195609
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
13102 Issued in CA
Legal business name
IMMACULATE CARE CENTR INC.
Practice address
24384 Sunnymead Blvd Ste 240
Moreno Valley, CA 92553-7765
Phone
(951) 243-0303
Fax
(951) 243-3006
NPI assigned
Feb 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Japhet Okey
Title
Program Director
Phone
(951) 243-0303

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YA0400X 13102 CA Primary

Addresses

Primary practice location

24384 Sunnymead Blvd Ste 240
Moreno Valley, CA 92553-7765

Mailing address

24384 Sunnymead Blvd Ste 240
Moreno Valley, CA 92553-7765
Phone (951) 243-0303

National Provider Directory

National Provider Directory
Tax ID family
Immaculate Care Center Inc5 organizations share this tax ID, including this one

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": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1528195609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24384 SUNNYMEAD BLVD STE 240",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925537765",
            "telephone_number": "951-243-0303",
            "fax_number": "951-243-3006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24384 SUNNYMEAD BLVD STE 240",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925537765",
            "telephone_number": "951-243-0303",
            "fax_number": "951-243-3006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMMACULATE CARE CENTR INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OKEY",
        "authorized_official_first_name": "JAPHET",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "951-243-0303",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "13102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moreno Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.