NPIMap

Organization Active NPI

Children'S Crisis Response Team Morongo Basin

  • Adolescent and Children Mental Health Clinic/Center
  • Yucca Valley, CA
National Provider Identifier
1699976597
Registry record updated Jul 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
License
ZZZ74743Z Issued in CA
Legal business name
CHILDREN'S CRISIS RESPONSE TEAM MORONGO BASIN
Practice address
56357 Pima Trail
Yucca Valley, CA 92284
Phone
(909) 382-3080
Fax
(909) 382-3105
NPI assigned
May 29, 2007
Organization subpart
Yes
Parent organization
DEPARTMENT OF BEHAVIORAL HEALTH, SAN BERNARDINO COUNTY, CAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 13, 2007

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

Authorized official

Name
Mr. Michael J Day
Title
Information Technology Manager
Phone
(909) 388-0570

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X ZZZ74743Z CA Primary

Addresses

Primary practice location

56357 Pima Trail
Yucca Valley, CA 92284

Mailing address

268 W. Hospitality Lane
Suite 400
San Bernardino, CA 92415-0026
Phone (909) 382-3080

Other identifiers 1

IdentifierTypeStateIssuer
3600036DGOtherCAMEDICAL PROVIDER NUMBER

National Provider Directory

National Provider Directory
Tax ID family
San Bernardino County D142 organizations share this tax ID, including this one
Part of
San Bernardino County D

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

56357 Pima Trl
Yucca Valley, CA 92284
Phone (760) 228-5242

NPI Registry JSON

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184284800000",
    "number": "1699976597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "268 W. HOSPITALITY LANE",
            "address_2": "SUITE 400",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924150026",
            "telephone_number": "909-382-3080",
            "fax_number": "909-382-3105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56357 PIMA TRAIL",
            "city": "YUCCA VALLEY",
            "state": "CA",
            "postal_code": "92284",
            "telephone_number": "909-382-3080",
            "fax_number": "909-382-3105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S CRISIS RESPONSE TEAM MORONGO BASIN",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DEPARTMENT OF BEHAVIORAL HEALTH, SAN BERNARDINO COUNTY, CA",
        "enumeration_date": "2007-05-29",
        "last_updated": "2007-07-13",
        "status": "A",
        "authorized_official_last_name": "DAY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "INFORMATION TECHNOLOGY MANAGER",
        "authorized_official_telephone_number": "909-388-0570",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "CA",
            "license": "ZZZ74743Z",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL PROVIDER NUMBER",
            "identifier": "3600036DG",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yucca Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2007; 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.