NPIMap

Organization Active NPI

Angel of Faith Non Profit Organization

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Wildomar, CA
National Provider Identifier
1750629564
Registry record updated Jan 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
ANGEL OF FAITH NON PROFIT ORGANIZATION
Practice address
21535 Palomar St
Suite B
Wildomar, CA 92595-7767
Phone
(951) 500-2774
Fax
(951) 358-0762
NPI assigned
Jan 29, 2013
Last updated
Jan 29, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2013

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

Authorized official

Name
Mr. Luis Alberto CruzNPI 1629116090
Title
President/Executive Director
Phone
(951) 500-2774

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
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU Primary

Addresses

Primary practice location

21535 Palomar St
Suite B
Wildomar, CA 92595-7767

Mailing address

4996 La Sierra Ave
Riverside, CA 92505-2612
Phone (951) 500-2774

National Provider Directory

National Provider Directory
Tax ID family
Angel of Faith Non Profit Organization3 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.

Locations

21535 Palomar St
Ste B
Wildomar, CA 92595
Phone (951) 500-2774

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": "1359417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359417600000",
    "number": "1750629564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4996 LA SIERRA AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925052612",
            "telephone_number": "951-500-2774",
            "fax_number": "951-358-0762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21535 PALOMAR ST",
            "address_2": "SUITE B",
            "city": "WILDOMAR",
            "state": "CA",
            "postal_code": "925957767",
            "telephone_number": "951-500-2774",
            "fax_number": "951-358-0762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGEL OF FAITH NON PROFIT ORGANIZATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-29",
        "last_updated": "2013-01-29",
        "status": "A",
        "authorized_official_last_name": "CRUZ",
        "authorized_official_first_name": "LUIS",
        "authorized_official_middle_name": "ALBERTO",
        "authorized_official_title_or_position": "PRESIDENT/EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "951-500-2774",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wildomar, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2013; 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.