HERITAGE GROUP HOMES, INC. (NPI# 1013469881) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013469881 |
| Entity Type | Organization |
| Organization Name | HERITAGE GROUP HOMES, INC. |
| Other Organization Name | HERITAGE YOUTH SERVICES 1 |
| Practice Address |
30 Country Wood Dr Phillips Ranch CA 91766-4818 |
| Mailing Address |
Po Box 8400 La Verne CA 91750-8400 |
| Practice Telephone | 9096233400 |
| Practice Fax Number | 9095998223 |
| Mailing Telephone | 9095998222 |
| Mailing Fax Number | 9095998223 |
| Enumeration Date | 2016-10-27 |
| Last Update Date | 2019-07-10 |
| Authorized Official Name | MARIA SERRATOS (PROGRAM ADMINISTRATOR) |
| Authorized Official Telephone | 9095998222 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | 197804150 | CA | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Heritage Group Homes I | Other Name - Individual/Organization |
| Heritage Youth Services 1 | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467904235 | Heritage Group Homes, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 16226 E. Benwick St, Valinda, CA 91744-1301 | 2016-10-27 |
| 1346804432 | Heritage Group Homes, Inc. | Point of Service | 158 Gentry St, Pomona, CA 91767-2100 | 2019-04-24 |
| 1285186981 | Heritage Group Homes, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 1940 Baseline Rd, La Verne, CA 91750-2148 | 2016-10-28 |
| 1306398185 | Heritage Group Homes, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 1923 E Eckerman Ave, West Covina, CA 91791-1113 | 2016-10-27 |
| 1396297172 | Heritage Group Homes, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 8814 Santa Fe Springs Rd, Whittier, CA 90606-2821 | 2016-10-27 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | HERITAGE GROUP HOMES, INC. | 158 Gentry St, Pomona, CA 91767-2100 |
| Street Address |
30 COUNTRY WOOD DR |
| City | PHILLIPS RANCH |
| State | CA |
| Zip Code | 91766-4818 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043828494 | Sydney Simone Johnson | Marriage & Family Therapist | 30 Country Wood Dr, Phillips Ranch, CA 91766-4818 | 2020-07-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851999494 | Justine Arce | Massage Therapist | 2063 Rancho Valley Drive Suite 320 #208, Pomona, CA 91766 | 2020-10-15 |
| 1699287938 | Monika Stephanie Wan | Pharmacist | 710 Rio Rancho Road, Pomona, CA 91766 | 2017-10-26 |
| 1306386966 | Teresa Le | Dentist | 1898 Wright St, Pomona, CA 91766 | 2017-03-02 |
| 1770971715 | Hanzel Mendez | Physical Therapist | 1080 Verbena Court, Pomona, CA 91766 | 2014-12-29 |
| 1902223589 | Anka Behavioral Health, Inc. | Community/Behavioral Health | 3 Cottontail Dr, Pomona, CA 91766 | 2014-03-21 |
| 1487075578 | Fenix Health Medical Group, Inc. | Family Medicine | 716 East Mission Blvd., Pomona, CA 91766 | 2013-12-17 |
| 1134556012 | Imperial Hospice, Inc. | Hospice Care, Community Based | 363 S Park Ave Ste 105, Pomona, CA 91766 | 2013-10-08 |
| 1497196349 | Cohen Sedgh, Manavi & Pakravan Dental Corporation | Dentist | 763 Rio Rancho Road Suite120, Pomona, CA 91766 | 2013-07-08 |
| 1245573567 | Terry Chang | Acupuncturist | 3060 W. Temple Ave., Pomona, CA 91766 | 2013-04-04 |
| 1215271085 | Emmanuel Castro | Counselor | 4 Village Loop, Phillips Ranch, CA 91766 | 2012-11-19 |
| Find all providers in zip 91766 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
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| 1144820499 | Catholic Charities of The Diocese of Oakland | Residential Treatment Facility, Emotionally Disturbed Children | 3700 Dorisa Ave, Oakland, CA 94605-4941 | 2020-10-27 |
| 1922607944 | Inspire A Youth, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 7556 Avenida Baja, Riverside, CA 92509-3449 | 2020-10-21 |
| 1235736554 | Yvonne Dionne Robinson | Residential Treatment Facility, Emotionally Disturbed Children | 1223 E Helmick St, Carson, CA 90746-3163 | 2020-10-09 |
| 1740897784 | Paradise Adolescent Home, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 602 Woodlark Dr, Suisun City, CA 94585-2244 | 2020-09-24 |
| 1548877657 | T & T House of Champions | Residential Treatment Facility, Emotionally Disturbed Children | 2115 High St, Oakland, CA 94601-4335 | 2020-09-23 |
| 1902412182 | Paradise Adolescent Home, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 136 Valdivia Cir, San Ramon, CA 94583-2228 | 2020-09-22 |
| 1073128492 | Samuel Campbell Jr. | Residential Treatment Facility, Emotionally Disturbed Children | 4200 Crescent Rock Ln, Bakersfield, CA 93311-2860 | 2020-09-11 |
| 1336753433 | Aaron's Boys Home | Residential Treatment Facility, Emotionally Disturbed Children | 5805 Capistrano Ave Ste E, Atascadero, CA 93422-7218 | 2020-09-04 |
| 1699389452 | Millie's Youth Services, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 2512 Havenscourt Blvd, Oakland, CA 94605-1935 | 2020-08-31 |
| 1538779871 | Hidden Treasures Foundation, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 1240 W 13th Ave, Escondido, CA 92025-5560 | 2020-08-02 |
| Find all providers with the same taxonomy | ||||
| City | PHILLIPS RANCH |
| Zip Code | 91766 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.