El Dodrado Mental Health

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

License

097004267 Issued in CA

Legal business name

EL DODRADO MENTAL HEALTH

Practice address

935 B Spring Street
Placerville, CA 95667-4543

Phone

(530) 621-6116

NPI assigned

Mar 30, 2009

Organization subpart

No

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

Authorized official

Name

Robert Bloom

Title

Cordinator

Phone

(530) 621-6332

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1238371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238371200000",
    "number": "1992947493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "935 B SPRING STREET",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956674543",
            "telephone_number": "530-621-6116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "935 B SPRING STREET",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956674543",
            "telephone_number": "530-621-6116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EL DODRADO MENTAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-30",
        "last_updated": "2009-03-30",
        "status": "A",
        "authorized_official_last_name": "BLOOM",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CORDINATOR",
        "authorized_official_telephone_number": "530-621-6332"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "CA",
            "license": "097004267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matilda A Ebagua
• John Ebenezer
• Jason Edward Eberhart-Phillips, MD
• Edca Lifeskill
• Corydon G Edgecomb, OD
• El Dorado Anesthesia Medical Group
• El Dorado Care Center, Inc.
• El Dorado County Community Health C
• El Dorado County Community Health Center
• El Dorado County Community Health Center

• Mental Illness Community Based Residential Treatment Facility in Placerville, CA
• Providers in Placerville, 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 Mar 30, 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.