The Arc of San Diego

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

Legal business name

THE ARC OF SAN DIEGO

Doing business as

Potter Group Home

Practice address

2930 Helix Street
Spring Valley, CA 91977

Phone

(619) 685-1175

Fax

(619) 234-3759

NPI assigned

Dec 4, 2007

Last updated

Jul 27, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Joseph Tontodonato

Title

Director of Operations

Phone

(619) 685-1175

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Potter Group Home Doing business as

Tax ID family

Potter Group Home2 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.

• The Arc of San Diego

  dba Turley Group Home

  • Intellectual Disabilities Intermediate Care Facility
  • Lakeside, CA
  • NPI 1730361569
  NPD tax ID

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

{
    "created_epoch": "1196726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469577600000",
    "number": "1902088735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 MARKET STREET",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92102",
            "telephone_number": "619-685-1175",
            "fax_number": "619-906-4031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2930 HELIX STREET",
            "city": "SPRING VALLEY",
            "state": "CA",
            "postal_code": "91977",
            "telephone_number": "619-685-1175",
            "fax_number": "619-234-3759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE ARC OF SAN DIEGO",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-04",
        "last_updated": "2016-07-27",
        "status": "A",
        "authorized_official_last_name": "TONTODONATO",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "619-685-1175",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05-G076",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Potter Group Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Orly Danielle Suveda, LCSW
• Dean Richard Taber, CPHT
• Amira Taylor
• Enrica Marie Taylor, APCC
• Teresa Thammavong
• The Empower Collective LLC.
• The Monterey Trellis
• Benjamin Them, RN
• Jacqueline Devera Them, RCP
• Sarah Ann Thomas-Carter, MS, LMFT

• Intellectual Disabilities Intermediate Care Facility in Spring Valley, CA
• Providers in Spring Valley, CA by specialty
• Intellectual Disabilities Intermediate Care Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2016; 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.