VETERANS ALCOHOLIC REHABILITATION PROGRAM (NPI# 1033311881) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033311881 |
| Entity Type | Organization |
| Organization Name | VETERANS ALCOHOLIC REHABILITATION PROGRAM |
| Other Organization Name | GIBSON HOUSE FOR MEN |
| Practice Address |
1100 N D St San Bernardino CA 92410-3524 |
| Practice Telephone | 9093813774 |
| Practice Fax Number | 9093816845 |
| Mailing Telephone | 9093813774 |
| Mailing Fax Number | 9093816845 |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2016-05-24 |
| Authorized Official Name | MR. OSCAR JIMENEZ (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 9093813774 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | 360004BN | CA | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Gibson House for Men | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992277867 | Veterans Alcoholic Rehabilitation Program | Counselor | 1100 N D St, San Bernardino, CA 92410-3524 | 2018-12-17 |
| Street Address |
1100 N D ST |
| City | SAN BERNARDINO |
| State | CA |
| Zip Code | 92410-3524 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356494769 | Richard Cornelius | Counselor | 1100 N D St, San Bernardino, CA 92410-3524 | 2007-01-19 |
| 1114541026 | Wesley Howard Gearhart | Counselor | 1100 N D St, San Bernardino, CA 92410-3524 | 2020-06-05 |
| 1871128843 | Johnny Angel Melendez | Counselor | 1100 N D St, San Bernardino, CA 92410-3524 | 2020-03-10 |
| 1912539396 | Jorge Andrew Gutierrez | Counselor | 1100 N D St, San Bernardino, CA 92410-3524 | 2020-02-04 |
| 1407487846 | Robert Romero Jr. | Counselor | 1100 N D St, San Bernardino, CA 92410-3524 | 2020-02-03 |
| 1336783422 | Manuel Acosta Gomez | Counselor | 1100 N D St, San Bernardino, CA 92410-3524 | 2019-10-31 |
| 1386297083 | Ranay Nichole Dato | Counselor | 1100 N D St, San Bernardino, CA 92410-3524 | 2019-07-22 |
| 1104479823 | Martin Allen Johnson | Counselor | 1100 N D St, San Bernardino, CA 92410-3524 | 2019-07-22 |
| 1639721467 | Courtney Elise Mera | Marriage & Family Therapist | 1100 N D St, San Bernardino, CA 92410-3524 | 2019-07-11 |
| 1144889742 | Michelle L Torres | Licensed Vocational Nurse | 1100 N D St, San Bernardino, CA 92410-3524 | 2019-06-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902303472 | Reina Elora Garcia | Student in an Organized Health Care Education/Training Program | 775 E Base Line St Spc 4, San Bernardino, CA 92410 | 2018-04-10 |
| 1558889881 | Salaunge Lopez | Non-emergency Medical Transport (VAN) | 25942 Baseline St Apt D203, San Bernardino, CA 92410 | 2017-09-07 |
| 1902328578 | Kelly Canady | Counselor | 1100 N. D St., San Bernardino, CA 92410 | 2017-07-14 |
| 1881058592 | Terron Thomas | Contractor | 445 South G, Unit B, San Bernardino, IN 92410 | 2016-04-08 |
| 1982064572 | Zachary Norton-martinez | Specialist/Technologist | 650 Del Rosa Dr, San Bernardino, CA 92410 | 2016-02-25 |
| 1003280934 | Brenda Boyle | Nurse Practitioner | 1455 East 3rd Street, San Bernardino, CA 92410 | 2015-11-16 |
| 1689045197 | Bryan Carter | Physician Assistant | 1455 E 3rd Street, San Bernardino, CA 92410 | 2015-10-09 |
| 1801270137 | Sac Health System | Clinic/Center | 250 South G Street, San Bernardino, CA 92410 | 2015-07-16 |
| 1467852269 | Wilson Dentistry, Inc. | Dentist | 1063 N. D St, San Bernardino, CA 92410 | 2014-08-28 |
| 1629405345 | Terrence John Forrester | Social Worker | 1455 E. 3rd St, San Bernardino, CA 92410 | 2013-09-27 |
| Find all providers in zip 92410 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508393356 | Harvey House, Inc. | Substance Abuse Rehabilitation Facility | 3512 Nolan St, San Bernardino, CA 92407-6250 | 2017-05-11 |
| 1639621865 | Veterans Alcoholic Rehabilitation Program, Inc. | Substance Abuse Rehabilitation Facility | 349 W 11th St, San Bernardino, CA 92410-3513 | 2016-11-04 |
| 1780041277 | Veterans Alcoholic Rehabilitation Program, Inc. | Substance Abuse Rehabilitation Facility | 384 11th St., San Bernardino, CA 92410-3524 | 2016-01-28 |
| 1508223090 | Veterans Alcoholic Rehabilitation Program, Inc. | Substance Abuse Rehabilitation Facility | 1069 N. 'd' St., San Bernardino, CA 92410-3524 | 2016-01-28 |
| 1821455403 | Veterans Alcoholic Rehabilitation Program, Inc. | Substance Abuse Rehabilitation Facility | 382 11th St., San Bernardino, CA 92410-3524 | 2016-01-27 |
| 1891152476 | Veterans Alcoholic Rehabilitation Program, Inc. | Substance Abuse Rehabilitation Facility | 1107 N. 'd' St., San Bernardino, CA 92410-3524 | 2016-01-27 |
| 1154788743 | Veterans Alcoholic Rehabilitation Program, Inc. | Substance Abuse Rehabilitation Facility | 1139 N. 'd' St., San Bernardino, CA 92410-3524 | 2016-01-27 |
| 1588021182 | Veterans Alcoholic Rehabilitation Program, Inc. | Substance Abuse Rehabilitation Facility | 1149 N. 'd' St., San Bernardino, CA 92410-3524 | 2016-01-27 |
| 1043677636 | Veterans Alcoholic Rehabilitation Program, Inc. | Substance Abuse Rehabilitation Facility | 1087 Stoddard St., San Bernardino, CA 92410-3524 | 2016-01-27 |
| 1699132282 | Veterans Alcoholic Rehabilitation Program, Inc. | Substance Abuse Rehabilitation Facility | 1078 North 'd' St., San Bernardino, CA 92410-3524 | 2016-01-27 |
| Find all providers in SAN BERNARDINO | ||||
| City | SAN BERNARDINO |
| Zip Code | 92410 |
Please comment or provide details below to improve the information on VETERANS ALCOHOLIC REHABILITATION PROGRAM.
| 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.