OPTIMIST BOYS' HOME AND RANCH, INC. (NPI# 1023551892) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023551892 |
| Entity Type | Organization |
| Organization Name | OPTIMIST BOYS' HOME AND RANCH, INC. |
| Other Organization Name | OPTIMIST CARSON |
| Practice Address |
20209 Tillman Ave Carson CA 90746-3066 |
| Mailing Address |
6957 N Figueroa St Los Angeles CA 90042-1245 |
| Practice Telephone | 3234433175 |
| Mailing Telephone | 3234433175 |
| Mailing Fax Number | 3233445124 |
| Enumeration Date | 2016-11-29 |
| Last Update Date | 2016-12-05 |
| Authorized Official Name | MR. SILVIO JOHN ORLANDO (CEO) |
| Authorized Official Telephone | 3234433127 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 323P00000X | Psychiatric Residential Treatment Facility | 191604301 | CA | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDI-CAL PROVIDER | 00781 | 01 |
| Other Name | Type Code |
|---|---|
| Optimist Carson | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770026544 | Optimist Boys' Home and Ranch, Inc. | Psychiatric Residential Treatment Facility | 1635 Silver Oak Ter, Los Angeles, CA 90041-3121 | 2016-11-29 |
| 1902935190 | Optimist Boys' Home and Ranch, Inc. | Community/Behavioral Health | 7003 N Figueroa St, Los Angeles, CA 90042-1247 | 2007-03-05 |
| 1639208259 | Optimist Boys' Home and Ranch, Inc. | Community/Behavioral Health | 14820 Wolfskill St, Mission Hills, CA 91345-1843 | 2007-03-02 |
| 1265561864 | Optimist Boys' Home and Ranch, Inc. | Community/Behavioral Health | 1635 Silver Oak Terrace, Los Angeles, CA 90041-3121 | 2007-03-02 |
| 1871622498 | Optimist Boys' Home and Ranch, Inc. | Community/Behavioral Health | 520 W Palmdale Blvd Ste Def&g, Palmdale, CA 93551-4229 | 2007-03-02 |
| 1518400282 | Optimist Boys' Home and Ranch, Inc. | Psychiatric Residential Treatment Facility | 14820 Wolfskill St, Mission Hills, CA 91345-1843 | 2016-11-29 |
| 1811430580 | Optimist Boys' Home and Ranch, Inc. | Psychiatric Residential Treatment Facility | 7130 Burnet Ave, Van Nuys, CA 91405-2963 | 2016-11-29 |
| 1013450857 | Optimist Boys' Home and Ranch, Inc. | Community/Behavioral Health | 16350 Filbert St, Sylmar, CA 91342-1002 | 2016-11-28 |
| 1710011028 | Optimist Boys' Home and Ranch, Inc. | Community/Behavioral Health | 16350 Filbert St, Sylmar, CA 91342-1002 | 2007-03-16 |
| 1477681096 | Optimist Boys' Home and Ranch, Inc. | Community/Behavioral Health | 6957 N Figueroa St, Los Angeles, CA 90042-1245 | 2007-03-02 |
| Street Address |
20209 TILLMAN AVE |
| City | CARSON |
| State | CA |
| Zip Code | 90746-3066 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912036518 | Optimist Boys' Home and Ranch | Community/Behavioral Health | 20209 Tillman Ave, Carson, CA 90746-3066 | 2007-03-02 |
| 1699958512 | Deborah L Payne | Social Worker | 20209 Tillman Ave, Carson, CA 90746-3066 | 2007-12-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174172837 | Darren Nakano Chiropractic, Professional Corporation | Chiropractor | 460 East Carson Plaza Drive, Suite 116, Carson, CA 90746 | 2019-09-05 |
| 1205370079 | Natalie Bland | Nurse Practitioner | 454 E. Carson Plaza Drive Suite 211, Carson, CA 90746 | 2016-12-13 |
| 1891146767 | Francis O Okpan | Nurse Practitioner | 17546 Buttonwood Ln, Carson, CA 90746 | 2016-06-22 |
| 1689049371 | Fresenius Medical Care Long Beach, LLC | Clinic/Center | 20710 Leapwood Ave Ste E, Carson, CA 90746 | 2015-12-07 |
| 1447649108 | Brandi Glenn | Occupational Therapist | 17811 Hazelwood Court, Carson, CA 90746 | 2015-01-20 |
| 1700226263 | Allen Berger | Counselor | 460 Est. Carson Plaza Dr. #119, Carson, CA 90746 | 2013-06-28 |
| 1902147036 | Basen Inc | Counselor | 460 Carson Plaza Drive, Ste 106, Carson, CA 90746 | 2013-03-14 |
| 1811238298 | Basen Inc | Counselor | 460 E Carsin Plaza Dr, #106, Carson, CA 90746 | 2013-03-08 |
| 1871858084 | Joseph H. Rodd M.d. Inc | Psychiatry & Neurology | 20710 S. Leapwood Ave., Suite B, Carson, CA 90746 | 2012-07-13 |
| 1467718601 | Laquesha Shonte Robinson | Counselor | 460 E. Carson Plaza Drive, Suite 200, Carson, CA 90746 | 2012-04-02 |
| Find all providers in zip 90746 | ||||
| Taxonomy Code | 323P00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Psychiatric Residential Treatment Facility |
| A residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four hour, therapeutically planned group living and learning situation where distinct and individualized psychotherapeutic interventions can take place. Residential treatment is a specific level of care to be differentiated from acute, intermediate, and long-term hospital care, when the least restrictive environment is maintained to allow for normalization of the patient’s surroundings. The RTF must be both physically and programmatically distinct if it is a part or subunit of a larger treatment program. An RTF is organized and professionally staffed to provide residential treatment of mental disorders to children and adolescents who have sufficient intellectual potential to respond to active treatment (that is, for whom it can reasonably be assumed that treatment of the mental disorder will result in an improved ability to function outside the RTF) for whom outpatient treatment, partial hospitalization or protected and structured environment is medically or psychologically necessary |
| Notes: Source: Champus Policy manual, Volume II, p. 6010.47M dated 9/12/94. Revision: Definition title revised 7/1/03 |
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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.