NPIMap

Organization Active NPI

Haynes Family of Programs

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • La Verne, CA
National Provider Identifier
1669905832
Registry record updated Jan 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
Legal business name
HAYNES FAMILY OF PROGRAMS
Practice address
233 West Baseline Road
La Verne, CA 91750-2353
Phone
(909) 593-2581
Fax
(909) 833-2998
NPI assigned
Apr 5, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2020

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

Authorized official

Name
Cassandra Jones
Title
Strtp Assistant Director
Phone
(909) 593-2581

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X Primary

Addresses

Primary practice location

233 West Baseline Road
La Verne, CA 91750-2353

Mailing address

233 West Baseline Rd
Box 400
La Verne, CA 91750-2353
Phone (909) 593-2581

Other identifiers 1

IdentifierTypeStateIssuer
0175.00.02OtherCAFACILITY LICENSE

Other names 1

  • HAYNES FP STRTP Other name

National Provider Directory

National Provider Directory
Tax ID family
Haynes Family of Programs4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

233 Baseline Rd
La Verne, CA 91750
Phone (909) 593-2581

233 Baseline Rd
#400
La Verne, CA 91750
Phone (909) 593-2581

Practitioners & affiliated clinicians

Practitioners 28

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1491350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580169600000",
    "number": "1669905832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 WEST BASELINE RD",
            "address_2": "BOX 400",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917502353",
            "telephone_number": "909-593-2581",
            "fax_number": "909-614-7466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 WEST BASELINE ROAD",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917502353",
            "telephone_number": "909-593-2581",
            "fax_number": "909-833-2998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAYNES FAMILY OF PROGRAMS",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-05",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "CASSANDRA",
        "authorized_official_title_or_position": "STRTP ASSISTANT DIRECTOR",
        "authorized_official_telephone_number": "909-593-2581"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FACILITY LICENSE",
            "identifier": "0175.00.02",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HAYNES FP STRTP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in La Verne, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 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.