LEROY HAYNES CENTER (NPI# 1467713743) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467713743 |
| Entity Type | Organization |
| Organization Name | LEROY HAYNES CENTER |
| Practice Address |
233 Baseline Rd La Verne CA 91750-2353 |
| Practice Telephone | 9095932581 |
| Practice Fax Number | 9095963567 |
| Enumeration Date | 2012-06-04 |
| Last Update Date | 2012-06-04 |
| Authorized Official Name | JENNIFER MOSSON (LICENSED PSYCHIATRIC TECHNICIAN) |
| Authorized Official Telephone | 9095923281 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | PT 34218 | CA | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | OUTPATIENT MENTAL HEALTH | 7565A | 01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | LEROY HAYNES CENTER | 233 Baseline, La Verne, CA 91750-2353 |
| Street Address |
233 BASELINE RD |
| City | LA VERNE |
| State | CA |
| Zip Code | 91750-2353 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952480642 | Debra Joan Evans | Marriage & Family Therapist | 233 Baseline Rd, La Verne, CA 91750-2353 | 2006-11-03 |
| 1467092239 | Casey Mintz | Counselor | 233 Baseline Rd, La Verne, CA 91750-2353 | 2020-01-09 |
| 1659916625 | Jessica Gomez | Counselor | 233 Baseline Rd, La Verne, CA 91750-2353 | 2019-11-13 |
| 1316592348 | Virginia Rios | Licensed Vocational Nurse | 233 Baseline Rd, La Verne, CA 91750-2353 | 2019-08-06 |
| 1588217996 | Eylim Julissa Quezada | Counselor | 233 Baseline Rd, La Verne, CA 91750-2353 | 2019-07-24 |
| 1942861075 | Suzanne Renee Moore | Social Worker | 233 Baseline Rd, La Verne, CA 91750 | 2019-06-28 |
| 1548821119 | Reginald Wade Cutliff | Counselor | 233 Baseline Rd, La Verne, CA 91750-2353 | 2019-06-25 |
| 1235795006 | Joycelyn Givens Stallworth | Marriage & Family Therapist | 233 Baseline Rd, La Verne, CA 91750-2353 | 2019-05-16 |
| 1629633664 | Jotanna Angelene Carretino | Licensed Vocational Nurse | 233 Baseline Rd, La Verne, CA 91750-2353 | 2019-05-06 |
| 1023589124 | Beverly Amaral | Marriage & Family Therapist | 233 Baseline Rd, La Verne, CA 91750-2353 | 2018-12-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548893324 | Alexis Ashley Andom | Occupational Therapist | 2061 Wright Ave., La Verne, CA 91750 | 2020-02-19 |
| 1952810855 | Wendy P Marrufo | Physical Therapist | 2590 Hayes Drive, La Verne, CA 91750 | 2017-09-22 |
| 1770006009 | Lineth Fiorella Florian | Family Medicine | 2333 Foothill Blvd, La Verne, CA 91750 | 2017-07-18 |
| 1205204765 | Heather Amanda Jantz Garcia | Specialist | 2061 Wright Avenue, Suite A-7, La Verne, CA 91750 | 2015-09-14 |
| 1255779864 | Carla Ureno | Counselor | 911 Herbine Street, La Verne, CA 91750 | 2013-06-06 |
| 1538459011 | Sameer K Hassamal | Psychiatry & Neurology | 4201 Hartshorn Ranch Pl, La Verne, CA 91750 | 2011-04-18 |
| 1134351695 | Robin Lorinne Clarkson | Physical Therapist | 2125 Wright Avenue, Ste C1, La Verne, CA 91750 | 2009-08-18 |
| 1477784767 | Sb Home Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 781 Canyon View Dr, Laverne, CA 91750 | 2009-08-04 |
| 1295978872 | Vi Hung Ly | Chiropractor | 1145 Foothill Blvd., La Verne, CA 91750 | 2009-04-13 |
| 1700906138 | Laura Nazaryan | Physical Therapist | 2123 Foothill Blvd Ste D, La Verne, CA 91750 | 2007-03-30 |
| Find all providers in zip 91750 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255879417 | David and Margaret Home, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 1350 3rd St, La Verne, CA 91750-5201 | 2017-02-08 |
| 1285186981 | Heritage Group Homes, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 1940 Baseline Rd, La Verne, CA 91750-2148 | 2016-10-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144820499 | Catholic Charities of The Diocese of Oakland | Residential Treatment Facility, Emotionally Disturbed Children | 3700 Dorisa Ave, Oakland, CA 94605-4941 | 2020-10-27 |
| 1922607944 | Inspire A Youth, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 7556 Avenida Baja, Riverside, CA 92509-3449 | 2020-10-21 |
| 1235736554 | Yvonne Dionne Robinson | Residential Treatment Facility, Emotionally Disturbed Children | 1223 E Helmick St, Carson, CA 90746-3163 | 2020-10-09 |
| 1740897784 | Paradise Adolescent Home, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 602 Woodlark Dr, Suisun City, CA 94585-2244 | 2020-09-24 |
| 1548877657 | T & T House of Champions | Residential Treatment Facility, Emotionally Disturbed Children | 2115 High St, Oakland, CA 94601-4335 | 2020-09-23 |
| 1902412182 | Paradise Adolescent Home, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 136 Valdivia Cir, San Ramon, CA 94583-2228 | 2020-09-22 |
| 1073128492 | Samuel Campbell Jr. | Residential Treatment Facility, Emotionally Disturbed Children | 4200 Crescent Rock Ln, Bakersfield, CA 93311-2860 | 2020-09-11 |
| 1336753433 | Aaron's Boys Home | Residential Treatment Facility, Emotionally Disturbed Children | 5805 Capistrano Ave Ste E, Atascadero, CA 93422-7218 | 2020-09-04 |
| 1699389452 | Millie's Youth Services, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 2512 Havenscourt Blvd, Oakland, CA 94605-1935 | 2020-08-31 |
| 1538779871 | Hidden Treasures Foundation, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 1240 W 13th Ave, Escondido, CA 92025-5560 | 2020-08-02 |
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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.