NPIMap

Organization Active NPI

Prodigy Healthcare, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Firebaugh, CA
National Provider Identifier
1689970766
Registry record updated Feb 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
PRODIGY HEALTHCARE, INC.
Practice address
1191 P St
(Mo, Rooms 1-20)
Firebaugh, CA 93622-2230
Phone
(888) 885-5580
Fax
(888) 888-5580
NPI assigned
Feb 7, 2011
Last updated
Feb 7, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
PRODIGY HEALTHCARE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 7, 2011

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

Authorized official

Name
Ms. Christine Nicole Howland, MBA
Title
Vice President
Phone
(888) 885-5580

Specialties & licenses 1

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

Addresses

Primary practice location

1191 P St
(Mo, Rooms 1-20)
Firebaugh, CA 93622-2230

Mailing address

PO Box 820
Fowler, CA 93625-0820
Phone (888) 885-5580

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGOtherCAMEDI-CAL

National Provider Directory

National Provider Directory
Tax ID family
Prodigy Healthcare Inc18 organizations share this tax ID, including this one
Part of
Prodigy Healthcare Inc

Other organizations with this tax ID 17

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

View all 17

Locations

1191 P St
Rm 120
Firebaugh, CA 93622

NPI Registry JSON

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

{
    "created_epoch": "1297036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297036800000",
    "number": "1689970766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 820",
            "city": "FOWLER",
            "state": "CA",
            "postal_code": "936250820",
            "telephone_number": "888-885-5580",
            "fax_number": "888-885-5580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1191 P ST",
            "address_2": "(MO, ROOMS 1-20)",
            "city": "FIREBAUGH",
            "state": "CA",
            "postal_code": "936222230",
            "telephone_number": "888-885-5580",
            "fax_number": "888-888-5580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRODIGY HEALTHCARE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRODIGY HEALTHCARE, INC.",
        "enumeration_date": "2011-02-07",
        "last_updated": "2011-02-07",
        "status": "A",
        "authorized_official_last_name": "HOWLAND",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "888-885-5580",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "PENDING",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Firebaugh, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 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.