NPIMap

Organization Active NPI

Compassion Pathway Behavioral Health LLC

Doing business as Anderson Creek SRF

  • Mental Illness Community Based Residential Treatment Facility
  • Anderson, CA
National Provider Identifier
1972284701
Registry record updated Jul 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
COMPASSION PATHWAY BEHAVIORAL HEALTH LLC
Doing business as
Anderson Creek SRF
Practice address
1901 Barney Rd
Anderson, CA 96007-4301
Phone
(530) 888-5000
NPI assigned
Jul 25, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2023

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

Authorized official

Name
Dr. Ifeanyi Ezeani, DBA
Title
Chief Executive Officer
Phone
(530) 888-5000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X Primary

Addresses

Primary practice location

1901 Barney Rd
Anderson, CA 96007-4301

Mailing address

5410 White Lotus Way
Elk Grove, CA 95757-4354
Phone (530) 888-5000

Other names 1

  • Anderson Creek SRF Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Compassion Pathway Behavioral Health LLC12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Locations

1901 Barney Rd
Anderson, CA 96007
Phone (530) 365-0321

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1690243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690243200000",
    "number": "1972284701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5410 WHITE LOTUS WAY",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957574354",
            "telephone_number": "530-888-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 BARNEY RD",
            "city": "ANDERSON",
            "state": "CA",
            "postal_code": "960074301",
            "telephone_number": "530-888-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPASSION PATHWAY BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-25",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A",
        "authorized_official_last_name": "EZEANI",
        "authorized_official_first_name": "IFEANYI",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "530-888-5000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DBA"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Anderson Creek SRF",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Anderson, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2023; 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.