REALLIFEDREAMS (NPI# 1457626889) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457626889 |
| Entity Type | Organization |
| Organization Name | REALLIFEDREAMS |
| Other Organization Name | LYNN L NICKENS, M.S.W., LCSW |
| Practice Address |
14240 Saint Andrews Dr Suite 101 Victorville CA 92395-4308 |
| Mailing Address |
1554 Barton Rd # 114 Redlands CA 92373-5457 |
| Practice Telephone | 7609278896 |
| Practice Fax Number | 8663829020 |
| Mailing Telephone | 7609278896 |
| Mailing Fax Number | 8663829020 |
| Enumeration Date | 2012-03-19 |
| Last Update Date | 2012-03-19 |
| Authorized Official Name | MS. LYNN NICKENS (PRESIDENT) |
| Authorized Official Telephone | 7609278896 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | 18158 | CA | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | NPI | 1114138252 | 01 |
| Other Name | Type Code |
|---|---|
| Lynn L Nickens, M.S.W., LCSW | Doing Business As Name - Organization |
| Street Address |
14240 SAINT ANDREWS DR SUITE 101 |
| City | VICTORVILLE |
| State | CA |
| Zip Code | 92395-4308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043837966 | Desert Ridge Transitional Care Center, Lp | Skilled Nursing Facility | 13300 11th Avenue, Victorville, CA 92395 | 2020-06-26 |
| 1376179093 | Catherine Ward | Speech-Language Pathologist | 13275 Mauka Ct, Victorville, CA 92395 | 2020-03-13 |
| 1174019228 | Laura Mercado Halterman | Family Medicine | 16519 Victor St Ste 307, Victorville, CA 92395 | 2018-07-02 |
| 1306337829 | Stephanie Ann Kruger | Behavior Technician | Sunny Days Inc 3602 Inland Empire Blvd., Ontario, CA 92395 | 2018-05-21 |
| 1861903924 | Debra L Andersen | Clinic/Center | 12830 Hesperia Road, Suite C, D, E, Victorville, CALIFORNIA 92395 | 2017-10-17 |
| 1790202141 | Joshua Powers | Physician Assistant | 12550 Hesperia Rd Ste 101, Victorville, CA 92395 | 2017-08-26 |
| 1043759491 | Kemp Individual & Family Therapy, Inc. | Marriage & Family Therapist | 14075 Hesperia Road, Suite 101, Victorville, CA 92395 | 2017-02-17 |
| 1740725969 | Abem Transportation Inc | Non-emergency Medical Transport (VAN) | 15000 7th St Ste F208, Victorville, CA 92395 | 2016-12-23 |
| 1447669379 | Tracie Girard | Nurse Practitioner | 17330 Bear Valley Road, Suite A106, Victorville, CA 92395 | 2014-08-05 |
| 1093153215 | Mitesh Patel | Surgery | 13010 Hesperia Rd Ste 400, Victorville, CA 92395 | 2013-06-10 |
| Find all providers in zip 92395 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568947323 | County of San Bernardino | Community/Behavioral Health | 15345 Bonanza Rd, Victorville, CA 92392-2499 | 2018-09-27 |
| 1558849141 | Valley Star Behavioral Health, Inc. | Community/Behavioral Health | 12188 Hesperia Road, Victorville, CA 92395-5822 | 2018-08-06 |
| 1407365430 | Life Skills Awareness | Community/Behavioral Health | 15353 Bonanza Rd Ste 2, Victorville, CA 92392-2465 | 2017-09-21 |
| 1235582404 | Greater Hope Foundation | Community/Behavioral Health | 14344 Cajon Avenue, Suite 101, 103, Victorville, CA 92392 | 2016-07-22 |
| 1881078517 | Harmeling Enterprises LLC | Community/Behavioral Health | 14443 Park Ave Ste A2, Victorville, CA 92392-2388 | 2015-07-13 |
| 1215208921 | People's Care Autism Services, Inc. | Community/Behavioral Health | 13901 Amargosa Rd Ste 2, Victorville, CA 92392-2409 | 2012-01-26 |
| 1649498593 | San Bernardino County Department of Behavioral Health | Community/Behavioral Health | 15505 Civic Dr, Victorville, CA 92392-2357 | 2007-04-23 |
| 1104954056 | Mental Health Systems, Inc. | Community/Behavioral Health | 15770 Mojave Dr, Suites K & L, Victorville, CA 92394-1934 | 2007-03-01 |
| 1568813129 | Greater Hope Foundation for Children Inc | Community/Behavioral Health | 14344 Cajon Ave, Suite 101, 102, 103, Victorville, CA 92392-4300 | 2016-06-24 |
| 1275947426 | Valley Star Behavioral Health, Inc. | Community/Behavioral Health | 12240 Hesperia Rd, Victorville, CA 92395-8309 | 2014-06-16 |
| Find all providers in VICTORVILLE | ||||
| City | VICTORVILLE |
| Zip Code | 92395 |
Please comment or provide details below to improve the information on REALLIFEDREAMS.
| 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.