RIDGEVIEW DRIVE RANCH, LLC (NPI# 1124366406) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124366406 |
| Entity Type | Organization |
| Organization Name | RIDGEVIEW DRIVE RANCH, LLC |
| Practice Address |
741 W Woodbury Rd Altadena CA 91001 |
| Mailing Address |
3085 Ridgeview Dr Altadena CA 91001-4527 |
| Practice Telephone | 8002961868 |
| Mailing Telephone | 8002961868 |
| Mailing Fax Number | 3108364500 |
| Enumeration Date | 2013-01-22 |
| Last Update Date | 2018-06-21 |
| Authorized Official Name | LARRY THORNTON (AUTHORIZED OFFICIAL) |
| Authorized Official Telephone | 6264823478 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | DHCS | 190627GP | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669825535 | Ridgeview Drive Ranch, LLC | Substance Abuse Rehabilitation Facility | 3323 Marengo Ave, Altadena, CA 91001 | 2016-07-15 |
| 1841435179 | Ridgeview Drive Ranch, LLC | Substance Abuse Rehabilitation Facility | 3085 Ridgeview Drive, Altadena, CA 91001 | 2008-12-16 |
| Street Address |
741 W WOODBURY RD |
| City | ALTADENA |
| State | CA |
| Zip Code | 91001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518455302 | Pax House Inc. | Clinic/Center | 2052 Lake Ave Ste F, Altadena, CA 91001 | 2018-04-26 |
| 1629592506 | Alfredo Manuel Mercado Jr. | Rehabilitation Practitioner | Tobinworld Mental Health, 920 E Boradway Street, Glendale, CA 91001 | 2017-08-01 |
| 1477000909 | Christopher Harris Jr. | Case Manager/Care Coordinator | 856 Figueroa Dr, Altadena, CA 91001 | 2016-09-01 |
| 1669825535 | Ridgeview Drive Ranch, LLC | Substance Abuse Rehabilitation Facility | 3323 Marengo Ave, Altadena, CA 91001 | 2016-07-15 |
| 1962864363 | Laura Peterson | Internal Medicine | 2225 Midwick Dr, Altadena, CA 91001 | 2016-03-24 |
| 1750741484 | Greta Francine Johnson | Psychiatry & Neurology | 800 S. Barranca, Covina, CA 91001 | 2016-02-23 |
| 1205211463 | Oscar Morales Aguirre | Licensed Vocational Nurse | 2145 North Marengo Ave, Altadena, CA 91001 | 2015-07-29 |
| 1811308703 | Growing Pains Individual, Family, and Couples Theraputic Services | Community/Behavioral Health | 29b Altadena Drive, Altadena, CA 91001 | 2014-05-13 |
| 1851727325 | Jennifer Sue-rurng Chen | Student in an Organized Health Care Education/Training Program | 2046 North Allen Avenue, Altadena, CA 91001 | 2013-09-17 |
| 1164730784 | James Thomas Klotzle | Counselor | 161 Purple Sage Ln, Altadena, CA 91001 | 2010-09-16 |
| Find all providers in zip 91001 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518455302 | Pax House Inc. | Clinic/Center | 2052 Lake Ave Ste F, Altadena, CA 91001 | 2018-04-26 |
| 1508100603 | Pax House LLC | Clinic/Center | 324 Wapello St, Altadena, CA 91001-4445 | 2012-11-15 |
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| 1104435734 | New Life Health Authority / Dba New Life LLC | Clinic/Center | 280 E Standley St, Ukiah, CA 95482-4414 | 2020-07-29 |
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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.