NPIMap

Organization Active NPI

2ND Home Incorporated

Doing business as 2nd Home, Inc.-San Jose Facility

  • Mental Illness Community Based Residential Treatment Facility
  • Clovis, CA
National Provider Identifier
1730716952
Registry record updated Jul 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
2ND HOME INCORPORATED
Doing business as
2nd Home, Inc.-San Jose Facility
Practice address
1797 San Jose Ave
Clovis, CA 93611-3078
Phone
(559) 790-2271
Fax
(559) 321-8367
NPI assigned
Mar 26, 2020
Last updated
Jul 9, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2020

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

Authorized official

Name
Jennifer FishNPI 1083211692
Title
Director
Phone
(559) 790-2271

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X Primary

Addresses

Primary practice location

1797 San Jose Ave
Clovis, CA 93611-3078

Mailing address

1187 N. Willow Ave. Ste 103 #22
Clovis, CA 93611-4411
Phone (559) 790-2271

Other names 1

  • 2nd Home, Inc.-San Jose Facility Doing business as

National Provider Directory

National Provider Directory
Tax ID family
2ND Home Inc-Sample Facility3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

  • 2ND Home Incorporated

    dba 2nd Home Inc.-Sample Facility

    • Mental Illness Community Based Residential Treatment Facility
    • Clovis, CA
    • NPI 1144950080
    NPD tax ID
  • 2ND Home Incorporated

    dba 2nd Home, Inc.-Tenaya Facility

    • Mental Illness Community Based Residential Treatment Facility
    • Fresno, CA
    • NPI 1346877594
    NPD tax ID

Practitioners & affiliated clinicians

Practitioners 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1585180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594252800000",
    "number": "1730716952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1187 N. WILLOW AVE. STE 103 #22",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936114411",
            "telephone_number": "559-790-2271",
            "fax_number": "559-321-8367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1797 SAN JOSE AVE",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936113078",
            "telephone_number": "559-790-2271",
            "fax_number": "559-321-8367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "2ND HOME INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-26",
        "last_updated": "2020-07-09",
        "certification_date": "2020-07-09",
        "status": "A",
        "authorized_official_last_name": "FISH",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "559-790-2271"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "2nd Home, Inc.-San Jose Facility",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clovis, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.