NPIMap

Organization Active NPI

Providence Community Services

  • Case Management Agency
  • Lemon Grove, CA
National Provider Identifier
1801920319
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
PROVIDENCE COMMUNITY SERVICES
Practice address
3240 Olive St
Apartment #50
Lemon Grove, CA 91945-1768
Phone
(619) 248-3835
NPI assigned
Mar 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Jamal Leo St.Cyr, B.A.
Title
Case Manager
Phone
(858) 300-0460

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary

Addresses

Primary practice location

3240 Olive St
Apartment #50
Lemon Grove, CA 91945-1768

Mailing address

3240 Olive St
Apartment #50
Lemon Grove, CA 91945-1768
Phone (619) 248-3835

Other names 1

  • Catalyst Program Other name

National Provider Directory

National Provider Directory
Tax ID family
Catalyst Program2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1801920319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3240 OLIVE ST",
            "address_2": "APARTMENT #50",
            "city": "LEMON GROVE",
            "state": "CA",
            "postal_code": "919451768",
            "telephone_number": "619-248-3835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3240 OLIVE ST",
            "address_2": "APARTMENT #50",
            "city": "LEMON GROVE",
            "state": "CA",
            "postal_code": "919451768",
            "telephone_number": "619-248-3835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE COMMUNITY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ST.CYR",
        "authorized_official_first_name": "JAMAL",
        "authorized_official_middle_name": "LEO",
        "authorized_official_title_or_position": "CASE MANAGER",
        "authorized_official_telephone_number": "858-300-0460",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "B.A."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Catalyst Program",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lemon Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.