NPIMap

Organization Active NPI

Mental Health Substance Abuse

  • Community/Behavioral Health Agency
  • Corona, CA
National Provider Identifier
1861715922
Registry record updated Mar 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
33023DN Issued in CA
Legal business name
MENTAL HEALTH SUBSTANCE ABUSE
Practice address
623 N Main St Ste D11
Corona, CA 92880-1408
Phone
(951) 737-2962
Fax
(951) 737-2783
NPI assigned
Mar 3, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2010

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

Authorized official

Name
Lupe (Guadalupe) Madrigal
Title
Supervisor
Phone
(951) 737-2962

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 33023DN CA Primary

Addresses

Primary practice location

623 N Main St Ste D11
Corona, CA 92880-1408

Mailing address

623 N Main St Ste D11
Corona, CA 92880-1408
Phone (951) 737-2962

National Provider Directory

National Provider Directory
Tax ID family
Riverside County Substance Abuse Program3 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

623 N Main St
Ste D11
Corona, CA 92878
Phone (951) 737-2962

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1267574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267574400000",
    "number": "1861715922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 N MAIN ST STE D11",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928801408",
            "telephone_number": "951-737-2962",
            "fax_number": "951-737-2783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 N MAIN ST STE D11",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928801408",
            "telephone_number": "951-737-2962",
            "fax_number": "951-737-2783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENTAL HEALTH SUBSTANCE ABUSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-03",
        "last_updated": "2010-03-03",
        "status": "A",
        "authorized_official_last_name": "MADRIGAL",
        "authorized_official_first_name": "LUPE (GUADALUPE)",
        "authorized_official_title_or_position": "SUPERVISOR",
        "authorized_official_telephone_number": "951-737-2962"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "33023DN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2010; 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.