PEPPERMINT RIDGE (NPI# 1508075508) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508075508 |
| Entity Type | Organization |
| Organization Name | PEPPERMINT RIDGE |
| Practice Address |
1581 Heartland Way Corona CA 92881-4180 |
| Mailing Address |
825 Magnolia Ave Corona CA 92879-3129 |
| Practice Telephone | 9512737346 |
| Practice Fax Number | 9517370726 |
| Mailing Telephone | 9512737320 |
| Mailing Fax Number | 9517370726 |
| Enumeration Date | 2007-05-22 |
| 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 | WYNN HOME | LTC61074F | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1295957728 | Peppermint Ridge | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 825 Magnolia Ave, Corona, CA 92804-3129 | 2007-05-03 |
| Street Address |
1581 HEARTLAND WAY |
| City | CORONA |
| State | CA |
| Zip Code | 92881-4180 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326682519 | Kadour and Hattar Inc | Pharmacy | 1973 Foothill Pkwy, Bldg F, Ste 106, Corona, CA 92881 | 2019-10-31 |
| 1861034944 | Jongguon Kim Dds Dental Corporation | Clinic/Center | 1973 Foothill Parkway, Suite 102, Corona, CA 92881 | 2019-10-10 |
| 1952874968 | Sasha M Dunn | Behavior Technician | 2144 Wembley Lane, Corona, Corona, CA 92881 | 2019-01-03 |
| 1053880450 | Tori Bissett Bowyer | Behavioral Analyst | 3439 White Sage St, Corona, CA 92881 | 2018-11-15 |
| 1104351097 | Victoria S. Brown | Family Medicine | 2071 Compton Ave #103, Corona, CA 92881 | 2017-04-27 |
| 1740695493 | Zoha Fazel | Counselor | 1240 E Ontario Ave Ste 102-182, Corona, CA 92881 | 2014-06-20 |
| 1720347222 | Neda Arjomandi | Podiatrist | 1881 California Ave Ste 102, Corona, CA 92881 | 2012-05-03 |
| 1891067864 | Valley Laparoscopic Surgical Associates, Inc. | Specialist | 2083 Compton Ave Ste 104, Corona, CA 92881 | 2012-02-06 |
| 1922396191 | Michelle Ann Mueller | Dietitian, Registered | 1800 Firethorne Plance, Apt. 108, Corona, CA 92881 | 2011-07-21 |
| 1558668772 | Jenna Lalas Eugenio | Physician Assistant | 2097 Compton Ave Ste 103, Corona, CA 92881 | 2011-02-24 |
| Find all providers in zip 92881 | ||||
| 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 |
| 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 |
| 1518987049 | Castles Care Homes, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1068 Elmhurst Street, Corona, CA 92880 | 2006-07-20 |
| Find all providers in CORONA | ||||
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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.