NPIMap

Organization Active NPI

Courage to Change, Inc.

  • Foster Care Agency
  • Exeter, CA
National Provider Identifier
1912368176
Registry record updated Mar 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foster Care AgencyTaxonomy code 253J00000X
License
247200700 Issued in CA
Legal business name
COURAGE TO CHANGE, INC.
Practice address
1230 N Anderson Rd
Exeter, CA 93221-9674
Phone
(559) 594-4855
Fax
(559) 594-0086
NPI assigned
Mar 16, 2016
Last updated
Mar 16, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2016

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

Authorized official

Name
Mrs. Susan GambiniNPI 1023581261
Title
Administrator
Phone
(559) 594-4855

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Children's Substance Abuse Rehabilitation Facility 3245S0500X 540014BN CA
Foster Care Agency 253J00000X 247200700 CA Primary

Addresses

Primary practice location

1230 N Anderson Rd
Exeter, CA 93221-9674

Mailing address

252 High Sierra Dr
Exeter, CA 93221-9502
Phone (559) 594-4855

National Provider Directory

National Provider Directory

Locations

1230 N Anderson Rd
Exeter, CA 93221
Phone (559) 594-4855

Practitioners & affiliated clinicians

Practitioners 49

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.

View all 49

NPI Registry JSON

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

{
    "created_epoch": "1458086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458086400000",
    "number": "1912368176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "252 HIGH SIERRA DR",
            "city": "EXETER",
            "state": "CA",
            "postal_code": "932219502",
            "telephone_number": "559-594-4855",
            "fax_number": "559-594-0086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 N ANDERSON RD",
            "city": "EXETER",
            "state": "CA",
            "postal_code": "932219674",
            "telephone_number": "559-594-4855",
            "fax_number": "559-594-0086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COURAGE TO CHANGE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-16",
        "last_updated": "2016-03-16",
        "status": "A",
        "authorized_official_last_name": "GAMBINI",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "559-594-4855",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": "CA",
            "license": "540014BN",
            "primary": false
        },
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": "CA",
            "license": "247200700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Exeter, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.