NPIMap

Organization Active NPI

Promesa Behavioral Health

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Merced, CA
National Provider Identifier
1538440755
Registry record updated Sep 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
1044 Issued in CA
Legal business name
PROMESA BEHAVIORAL HEALTH
Practice address
2815 G St
Merced, CA 95340-2133
Phone
(209) 725-3114
Fax
(209) 725-3114
NPI assigned
Sep 1, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2011

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

Authorized official

Name
Lisa Weigant, MA
Title
Ceo
Phone
(559) 439-5437

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 1044 CA Primary

Addresses

Primary practice location

2815 G St
Merced, CA 95340-2133

Mailing address

7475 N Palm Ave Ste 107
Fresno, CA 93711-5763
Phone (559) 439-5437

Other identifiers 1

IdentifierTypeStateIssuer
1044MedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
Promesa Behavioral Health FCHN39 organizations share this tax ID, including this one

Other organizations with this tax ID 38

Organizations that report the same tax identification number in the National Provider Directory.

View all 38

Locations

2815 G St
Merced, CA 95340
Phone (209) 725-3114

NPI Registry JSON

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

{
    "created_epoch": "1314835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314835200000",
    "number": "1538440755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7475 N PALM AVE STE 107",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937115763",
            "telephone_number": "559-439-5437",
            "fax_number": "559-439-5411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2815 G ST",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953402133",
            "telephone_number": "209-725-3114",
            "fax_number": "209-725-3114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMESA BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-01",
        "last_updated": "2011-09-01",
        "status": "A",
        "authorized_official_last_name": "WEIGANT",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "559-439-5437",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "CA",
            "license": "1044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1044",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Merced, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2011; 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.