PEPPERMINT RIDGE (NPI# 1568674703) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568674703 |
| Entity Type | Organization |
| Organization Name | PEPPERMINT RIDGE |
| Practice Address |
4045 Castle Pines Way Corona CA 92883-0603 |
| Mailing Address |
825 Magnolia Ave Corona CA 92879-3129 |
| Practice Telephone | 9512737347 |
| Mailing Telephone | 9512737320 |
| Mailing Fax Number | 9517370726 |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | 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 | VILLA VADNAIS | LTC60836F | 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 |
| 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 |
4045 CASTLE PINES WAY |
| City | CORONA |
| State | CA |
| Zip Code | 92883-0603 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710496815 | Onyinye Yvonne Johnson | Nurse Practitioner | 27223 Lasso Way, Corona, CA 92883 | 2017-09-21 |
| 1215376850 | Jennifer Carol Bard | Speech-Language Pathologist | 4194 Floyd Drive, Corona, CA 92883 | 2013-06-17 |
| 1023359619 | Richard Joon Kim | Pharmacist | 4315 Driving Range Rd, Corona, CA 92883 | 2013-03-07 |
| 1740590330 | Kim-thoa Thi Vu | Pharmacist | 2243 Eagle Glen Parkway, Corona, CA 92883 | 2010-10-15 |
| 1114232154 | Always 'tfy' Hospice, Inc. | Hospice Care, Community Based | 9064 Pulsar Court, Ste E, Corona, CA 92883 | 2010-08-14 |
| 1952553844 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 11950 Depalma Rd, Corona, CA 92883 | 2008-10-22 |
| 1497979280 | Sang C Paik Dds | Dentist | 3811 Bedford Canyon Rd, Suite 105, Corona, CA 92883 | 2007-04-12 |
| 1285615864 | Mallory Leon | Family Medicine | 25085 Pacific Crest Street, Corona, CA 92883 | 2005-11-09 |
| 1326038993 | Chan Woo Lee | Optometrist | 2790 Cabot Drive, Suite 135, Corona, CA 92883 | 2005-10-25 |
| 1659575736 | Optique Optometry, A Professional Corporation | Optometrist | 2790 Cabot Drive, Suite 135, Corona, CA 92883 | 2007-06-13 |
| Find all providers in zip 92883 | ||||
| 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 |
| 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.