NPIMap

Organization Active NPI

East Valley Charlee Inc.

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Yucaipa, CA
National Provider Identifier
1962073965
Registry record updated Dec 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
Legal business name
EAST VALLEY CHARLEE INC.
Practice address
12820 Grant St.
Yucaipa, CA 92399-4950
Phone
(909) 797-3153
NPI assigned
Jul 9, 2021
Organization subpart
Yes
Parent organization
EAST VALLEY CHARLEE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 24, 2025

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

Authorized official

Name
Tina Collins, LMFT
Title
Executive Director
Phone
(909) 307-5777

Specialties & licenses 1

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

Addresses

Primary practice location

12820 Grant St.
Yucaipa, CA 92399-4950

Mailing address

101 E. Redlands Blvd
Suite 285
Redlands, CA 92373-5776
Phone (909) 307-5777

Other names 1

  • Grant (Pinta) Group Home Other name

National Provider Directory

National Provider Directory
Tax ID family
East Valley Charlee Inc3 organizations share this tax ID, including this one
Part of
East Valley Charlee Inc

Other organizations with this tax ID 2

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1625788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766534400000",
    "number": "1962073965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E. REDLANDS BLVD",
            "address_2": "SUITE 285",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923735776",
            "telephone_number": "909-307-5777",
            "fax_number": "909-307-5776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12820 GRANT ST.",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "923994950",
            "telephone_number": "909-797-3153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST VALLEY CHARLEE INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EAST VALLEY CHARLEE, INC.",
        "enumeration_date": "2021-07-09",
        "last_updated": "2025-12-24",
        "certification_date": "2025-12-24",
        "status": "A",
        "authorized_official_last_name": "COLLINS",
        "authorized_official_first_name": "TINA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "909-307-5777",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grant (Pinta) Group Home",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Grant (Pinta) Group Home",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Yucaipa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2025; 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.