NPIMap

Organization Active NPI

Center for Positive Changes Stay

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • San Diego, CA
National Provider Identifier
1881162071
Registry record updated Jan 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
Legal business name
CENTER FOR POSITIVE CHANGES STAY
Practice address
5972 Kenyatta CT
San Diego, CA 92114-5512
Phone
(619) 677-2879
Fax
(619) 660-6604
NPI assigned
Nov 6, 2018
Last updated
Jan 15, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2019

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

Authorized official

Name
Deanna Mellos
Title
Director
Phone
(619) 248-0552

Specialties & licenses 1

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

Addresses

Primary practice location

5972 Kenyatta CT
San Diego, CA 92114-5512

Mailing address

9628 Campo Rd Ste M
Spring Valley, CA 91977-1233
Phone (619) 660-3886

Other names 1

  • Center for Positive Changes STAY 2 Other name

National Provider Directory

National Provider Directory
Tax ID family
Center for Positive Changes Stay5 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.

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": "1541462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547510400000",
    "number": "1881162071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9628 CAMPO RD STE M",
            "city": "SPRING VALLEY",
            "state": "CA",
            "postal_code": "919771233",
            "telephone_number": "619-660-3886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5972 KENYATTA CT",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921145512",
            "telephone_number": "619-677-2879",
            "fax_number": "619-660-6604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR POSITIVE CHANGES STAY",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-06",
        "last_updated": "2019-01-15",
        "status": "A",
        "authorized_official_last_name": "MELLOS",
        "authorized_official_first_name": "DEANNA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "619-248-0552"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Center for Positive Changes STAY 2",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2019; 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.