Boys & Girls Clubs of Greater Redlands-Riverside

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

BOYS & GIRLS CLUBS OF GREATER REDLANDS-RIVERSIDE

Practice address

1251 Clay St
Redlands, CA 92374-3257

Phone

(909) 731-5576

NPI assigned

Dec 26, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Martha Irene Daggett, DSW, MS, LMFT

Title

Dir. of Behavioral Health Services

Phone

(909) 731-5576

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1735171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735171200000",
    "number": "1831907518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1251 CLAY ST",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923743257",
            "telephone_number": "909-731-5576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1251 CLAY ST",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923743257",
            "telephone_number": "909-731-5576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOYS & GIRLS CLUBS OF GREATER REDLANDS-RIVERSIDE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-26",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "status": "A",
        "authorized_official_last_name": "DAGGETT",
        "authorized_official_first_name": "MARTHA",
        "authorized_official_middle_name": "IRENE",
        "authorized_official_title_or_position": "DIR. OF BEHAVIORAL HEALTH SERVICES",
        "authorized_official_telephone_number": "909-731-5576",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DSW, MS, LMFT"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Bourang, FNP
• Robert CM Bourne, M.D.
• Jana K Boyd, JANA BOYD, PHD
• Vicky Reyes Boykins, LMFT
• Anneliese Mary Elizabeth Boyle
• Bradford Healthcare
• Donald Damon Bradley, MSW
• Rebecca Lee Bradshaw, CMT
• Shyam Brahmbhatt, D.M.D.
• Brand New Pharmacy Inc

• Mental Health Clinic/Center (Including Community Mental Health Center) in Redlands, CA
• Providers in Redlands, CA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2024; 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.