Merrill Community Serv Inc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

360016AN Issued in CA

Legal business name

MERRILL COMMUNITY SERV INC

Practice address

9161 Sierra Ave
Suite 200
Fontana, CA 92335-4729

Phone

(909) 823-0609

Fax

(909) 823-4187

NPI assigned

Sep 26, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Warren Deavon Batiste

Title

Executive Director

Phone

(909) 823-0609

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1190764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236038400000",
    "number": "1962699751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9161 SIERRA AVE",
            "address_2": "SUITE 200",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923354729",
            "telephone_number": "909-823-0609",
            "fax_number": "909-823-4187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9161 SIERRA AVE",
            "address_2": "SUITE 200",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923354729",
            "telephone_number": "909-823-0609",
            "fax_number": "909-823-4187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERRILL COMMUNITY SERV INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-26",
        "last_updated": "2009-03-03",
        "status": "A",
        "authorized_official_last_name": "BATISTE",
        "authorized_official_first_name": "WARREN",
        "authorized_official_middle_name": "DEAVON",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "909-823-0609",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "360016AN",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MED I CAL",
            "identifier": "363648",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rosalyn Mendoza, RDA
• Tyler Nicholas Mendoza, RT
• Sarahi Mera
• Francisco Javier Merino, D.O.
• Tiffany Pamela Merrick Mikhael, DO
• Paymon Mesgarzadeh, M.D.
• Kimberly May Messenger, PHARM.D.
• Jeannie Valerie Meza
• Kitchie Ramos Miana, R.D.
• Vanessa M Michelena Basantes, PA-C

• Community/Behavioral Health Agency in Fontana, CA
• Providers in Fontana, CA by specialty
• Community/Behavioral Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2009; 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.