NPIMap

Organization Active NPI

Eggleston Youth Centers, Inc.

Doing business as Eggleston Substance Abuse and Education Program

  • Substance Abuse Rehabilitation Facility
  • Irwindale, CA
National Provider Identifier
1649517764
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
EGGLESTON YOUTH CENTERS, INC.
Practice address
13001 Ramona Blvd Ste E
Irwindale, CA 91706-3752
Phone
(626) 480-8107
NPI assigned
Jan 9, 2013
Last updated
Jun 16, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Authorized official

Name
Cassandra Elaine Gibson-Judkins, LCSWNPI 1780725887
Title
Assistant Executive Director
Phone
(626) 480-8107

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X NU Primary

Addresses

Primary practice location

13001 Ramona Blvd Ste E
Irwindale, CA 91706-3752

Mailing address

13001 Ramona Blvd., Suite E
Irwindale, CA 91706
Phone (626) 627-6000

Other identifiers 3

IdentifierTypeStateIssuer
197427OtherCAMASTER PROVIDER FILE NO.
7427OtherCADRUG MEDI-CAL BILLING NO.
190716ANOtherCADEPT OF ALCOHOL AND DRUG PROGRAMS

Other names 1

  • Eggleston Substance Abuse and Education Program Other name

National Provider Directory

National Provider Directory
Tax ID family
Eggleston Youth Centers Inc15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1357689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1649517764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13001 RAMONA BLVD., SUITE E",
            "city": "IRWINDALE",
            "state": "CA",
            "postal_code": "91706",
            "telephone_number": "626-627-6000",
            "fax_number": "626-480-7688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13001 RAMONA BLVD STE E",
            "city": "IRWINDALE",
            "state": "CA",
            "postal_code": "917063752",
            "telephone_number": "626-480-8107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EGGLESTON YOUTH CENTERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-09",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "GIBSON-JUDKINS",
        "authorized_official_first_name": "CASSANDRA",
        "authorized_official_middle_name": "ELAINE",
        "authorized_official_title_or_position": "ASSISTANT EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "626-480-8107",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASTER PROVIDER FILE NO.",
            "identifier": "197427",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRUG MEDI-CAL BILLING NO.",
            "identifier": "7427",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF ALCOHOL AND DRUG PROGRAMS",
            "identifier": "190716AN",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eggleston Substance Abuse and Education Program",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Eggleston Substance Abuse and Education Program",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Irwindale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.