PEPPERMINT RIDGE (NPI# 1295957728) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295957728 |
| Entity Type | Organization |
| Organization Name | PEPPERMINT RIDGE |
| Practice Address |
825 Magnolia Ave Corona CA 92804-3129 |
| Practice Telephone | 9512737320 |
| Practice Fax Number | 9517370726 |
| Mailing Telephone | 9512737320 |
| Mailing Fax Number | 9517370726 |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. JOHN A. GARRETT (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 9512737320 |
| Authorized Official Credential | M.S.W. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | CA | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | CONNER RESIDENCE | LTC60227F | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508075508 | Peppermint Ridge | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1581 Heartland Way, Corona, CA 92881-4180 | 2007-05-22 |
| 1689896813 | Peppermint Ridge | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 779 Ford Street, Corona, CA 92879-2507 | 2007-05-03 |
| 1063634541 | Peppermint Ridge | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 825 Magnolia Ave, Corona, CA 92879-3129 | 2007-05-03 |
| 1568674703 | Peppermint Ridge | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4045 Castle Pines Way, Corona, CA 92883-0603 | 2007-05-03 |
| 1285847301 | Peppermint Ridge | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 825 Magnolia Ave, Corona, CA 92879-3129 | 2007-05-07 |
| 1083827109 | Peppermint Ridge | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 825 Magnolia Ave, Corona, CA 92879-3129 | 2007-05-07 |
| Street Address |
825 MAGNOLIA AVE |
| City | CORONA |
| State | CA |
| Zip Code | 92804-3129 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063634541 | Peppermint Ridge | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 825 Magnolia Ave, Corona, CA 92879-3129 | 2007-05-03 |
| 1285847301 | Peppermint Ridge | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 825 Magnolia Ave, Corona, CA 92879-3129 | 2007-05-07 |
| 1083827109 | Peppermint Ridge | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 825 Magnolia Ave, Corona, CA 92879-3129 | 2007-05-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811517261 | Crown Care Hospice Inc | Hospice Care, Community Based | 10568 Magnolia Ave., Suite106, Stanton, CA 92804 | 2020-04-24 |
| 1154971646 | Leita Pawline Lawrene | Technician | 900 S Beach Blvd # 132, Anaheim, CA 92804 | 2019-09-17 |
| 1942767611 | Yasmen Abuyousef | Behavior Technician | 714 W Commonweath Ave, Suite C, Fullerton, CA 92804 | 2019-02-28 |
| 1225501224 | Brandon Pourazima | Physician Assistant | 631 S Brookhurst St Ste 213b, Anaheim, CA 92804 | 2019-01-02 |
| 1043782576 | Origins Home Health Care Inc. | Home Health | 137 1/2 S So Knott, Anaheim, CA 92804 | 2018-12-21 |
| 1346762150 | Inhee Shinn | Acupuncturist | 1717 W. Ball Road., Anaheim, CA 92804 | 2017-07-13 |
| 1689122459 | Jayanthi Ravikumar Md Inc | Physical Medicine & Rehabilitation | 3356 W Ball Road, #216, Anaheim, CA 92804 | 2016-09-21 |
| 1215307954 | Tuan Manh Hoang | Dentist | 1317 S. Courtright Street, Anaheim, CA 92804 | 2015-10-06 |
| 1598101602 | Optimal Sleep Center | Clinical Medical Laboratory | 3340 West Ball Road Suite B, Anaheim, CA 92804 | 2013-05-15 |
| 1376885673 | Michelle Lananh Dang | Pharmacist | 1913 W. Elm Pl, Anaheim, CA 92804 | 2013-03-25 |
| Find all providers in zip 92804 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528671633 | Eliaa, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1229 Kelley Avenue, Corona, CA 92882-4207 | 2020-08-28 |
| 1427592963 | Carissa Group Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1048 Stowell Ranch Cir, Corona, CA 92881-4739 | 2016-12-16 |
| 1568771756 | Castles Care Homes, Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 255 E. Rincon Street, Suite #212, Corona, CA 92879-1369 | 2010-10-05 |
| 1942532262 | Peppermint Ridge Dudley Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4289 Shoalcreek Dr, Corona, CA 92883-0724 | 2010-02-11 |
| 1255580668 | Castles Care Homes, Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 7302 Excelsior Dr, Corona, CA 92880 | 2008-09-10 |
| 1437308848 | Castles Care Homes,inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1481 Teakwood Place, Corona, CA 92880 | 2008-09-10 |
| 1508075508 | Peppermint Ridge | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1581 Heartland Way, Corona, CA 92881-4180 | 2007-05-22 |
| 1689896813 | Peppermint Ridge | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 779 Ford Street, Corona, CA 92879-2507 | 2007-05-03 |
| 1063634541 | Peppermint Ridge | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 825 Magnolia Ave, Corona, CA 92879-3129 | 2007-05-03 |
| 1568674703 | Peppermint Ridge | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4045 Castle Pines Way, Corona, CA 92883-0603 | 2007-05-03 |
| Find all providers in CORONA | ||||
Please comment or provide details below to improve the information on PEPPERMINT RIDGE.
| 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.