Rancho San Antonio Boys Home, Inc.

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

RANCHO SAN ANTONIO BOYS HOME, INC.

Doing business as

Rancho San Antonio

Practice address

21044 Plummer St
Chatsworth, CA 91311-4903

Phone

(818) 882-6400

Fax

(818) 882-6404

NPI assigned

Aug 1, 2022

Last updated

Nov 18, 2024By the provider in NPPES

Organization subpart

Yes

Parent organization

RANCHO SAN ANTONIO BOYS HOME, INC.As reported in NPPES

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

Authorized official

Name

Kelley Butler, LCSW

Title

Mental Health Director

Phone

(818) 882-6400

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 2

• Rancho San Antonio Doing business as
• RSA St Anthonys House STRTP Other name

Tax ID family

Rancho San Antonio Boys Home Inc3 organizations share this tax ID, including this one

Part of

Rancho San Antonio Boys Home Inc

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Rancho San Antonio Boys Home Inc.

  dba Rancho San Antonio

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Chatsworth, CA
  • NPI 1023576261
  NPD tax ID
• Rancho San Antonio Boys Home Inc.

  dba Rancho San Antonio

  • Community/Behavioral Health Agency
  • Chatsworth, CA
  • NPI 1245613678
  NPD tax ID

Locations

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

{
    "created_epoch": "1659312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731888000000",
    "number": "1952038929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21000 PLUMMER ST",
            "city": "CHATSWORTH",
            "state": "CA",
            "postal_code": "913114903",
            "telephone_number": "818-882-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21044 PLUMMER ST",
            "city": "CHATSWORTH",
            "state": "CA",
            "postal_code": "913114903",
            "telephone_number": "818-882-6400",
            "fax_number": "818-882-6404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANCHO SAN ANTONIO BOYS HOME, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RANCHO SAN ANTONIO BOYS HOME, INC.",
        "enumeration_date": "2022-08-01",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A",
        "authorized_official_last_name": "BUTLER",
        "authorized_official_first_name": "KELLEY",
        "authorized_official_title_or_position": "MENTAL HEALTH DIRECTOR",
        "authorized_official_telephone_number": "818-882-6400",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "19KI",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rancho San Antonio",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "RSA St Anthonys House STRTP",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "RSA St Anthonys House STRTP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Marilyn Rebeca Rabe
• Radiance Recovery Inc.
• Aurora Yaneth Ramirez
• Rancho San Antonio Boys Home Inc. (Rancho San Antonio)
• Rancho San Antonio Boys Home Inc. (Rancho San Antonio)
• Eleanor Reasoner, OTR
• Mona R Reeves, RN
• Reflection and Recovery, Inc.
• Jeffrey Reid, AU.D
• Relief Films Inc (Relief Services Inc.)

• Mental Illness Community Based Residential Treatment Facility in Chatsworth, CA
• Providers in Chatsworth, CA by specialty
• Mental Illness Community Based Residential Treatment Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 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.