NPIMap

Organization Active NPI

Mary'S Shelter

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Santa Ana, CA
National Provider Identifier
1821529199
Registry record updated Oct 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
306000793 Issued in CA
Legal business name
MARY'S SHELTER
Practice address
18221 E 17TH St
Santa Ana, CA 92705-2676
Phone
(714) 730-0930
NPI assigned
Mar 27, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2020

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

Authorized official

Name
Kelli Cayley Strickland, LCSW
Title
Lead Social Worker
Phone
(714) 730-0930

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X 306000793 CA Primary

Addresses

Primary practice location

18221 E 17TH St
Santa Ana, CA 92705-2676

Mailing address

18221 E 17TH St
Santa Ana, CA 92705-2676
Phone (714) 730-0930

National Provider Directory

National Provider Directory
Tax ID family
Mary'S Shelter5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Ownership & related parties

Subparts reporting this organization as parent 4

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1490572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601942400000",
    "number": "1821529199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18221 E 17TH ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927052676",
            "telephone_number": "714-730-0930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18221 E 17TH ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927052676",
            "telephone_number": "714-730-0930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY'S SHELTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-27",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A",
        "authorized_official_last_name": "STRICKLAND",
        "authorized_official_first_name": "KELLI",
        "authorized_official_middle_name": "CAYLEY",
        "authorized_official_title_or_position": "LEAD SOCIAL WORKER",
        "authorized_official_telephone_number": "714-730-0930",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "CA",
            "license": "306000793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 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.