Ettie Lee Homes, Inc

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

ETTIE LEE HOMES, INC

Doing business as

Ettie Lee Homes Pomona

Practice address

160 E Holt Ave Ste B
Pomona, CA 91767-5407

Phone

(909) 620-2521

Fax

(909) 620-9793

NPI assigned

Oct 4, 2006

Organization subpart

No

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

Authorized official

Name

Windy Luna Perez

Title

Qa Manager

Phone

(909) 620-2521

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Ettie Lee Homes Pomona Doing business as

Tax ID family

Ettie Lee Homes Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

• Ettie Lee Homes, Inc

  dba Ettie Lee Youth and Family Services

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Redlands, CA
  • NPI 1174157960
  NPD tax ID
• Ettie Lee Homes, Inc

  dba Ettie Lee Youth and Family Services

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Fontana, CA
  • NPI 1275167066
  NPD tax ID
• Ettie Lee Homes, Inc

  dba Ettie Lee Youth and Family Services

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Bloomington, CA
  • NPI 1356975148
  NPD tax ID

Locations

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729728000000",
    "number": "1992890057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 W FOOTHILL BLVD STE 13",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917413386",
            "telephone_number": "626-960-4861",
            "fax_number": "626-960-6241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 E HOLT AVE STE B",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917675407",
            "telephone_number": "909-620-2521",
            "fax_number": "909-620-9793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETTIE LEE HOMES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A",
        "authorized_official_last_name": "LUNA PEREZ",
        "authorized_official_first_name": "WINDY",
        "authorized_official_title_or_position": "QA MANAGER",
        "authorized_official_telephone_number": "909-620-2521"
    },
    "taxonomies": [
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "CA",
            "license": "C07933",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SBCDBH",
            "identifier": "36IHCR",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LACDMH",
            "identifier": "7453A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ettie Lee Homes Pomona",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ettie Lee Homes Pomona",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elisa Marie Estrada, RN
• John Estrada
• Monse Estrada
• Valerie Estrada
• Gabriel Estremera, M.D.
• Eva Eufracio
• Martha Eufracio, MSW, ASW
• Chazz Brittney Evans, PT, DPT
• Joanne Tina Evans, PHARM D
• Tkeyah Evans

• Adolescent and Children Mental Health Clinic/Center in Pomona, CA
• Providers in Pomona, CA by specialty
• Adolescent and Children Mental Health Clinic/Center in California

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