COLLINS LAKE AUTISM CENTER (NPI# 1568801017) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568801017 |
| Entity Type | Organization |
| Organization Name | COLLINS LAKE AUTISM CENTER |
| Practice Address |
246 Encinal Road Cleveland NM 87715 |
| Mailing Address |
710 Gildersleeve St Santa Fe NM 87505-2636 |
| Practice Telephone | 2816300827 |
| Mailing Telephone | 2816300827 |
| Enumeration Date | 2013-06-18 |
| Last Update Date | 2013-06-18 |
| Authorized Official Name | STEPHEN ANDREW SMABY (FOUNDER) |
| Authorized Official Telephone | 2816300827 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| Street Address |
246 ENCINAL ROAD |
| City | CLEVELAND |
| State | NM |
| Zip Code | 87715 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730780404 | Lyuba Vitkin | Home Health Aide | 6608 Kingswood Dr, Cleveland, OH 44124-4229 | 2020-11-08 |
| 1659972305 | Rosemary Jean Snow | Pharmacist | 5841 W 130th St, Cleveland, OH 44130-9308 | 2020-11-07 |
| 1962003848 | Jessica John | Home Health Aide | 4065 W 143rd St, Cleveland, OH 44135-1471 | 2020-11-05 |
| 1760083794 | Susan Carol Flatt | Behavior Technician | 415 Heritage Hills Cir Ne, Cleveland, TN 37323-5156 | 2020-11-05 |
| 1326649427 | Brooke Iames | Prosthetist | 2182 W 38th St Uppr, Cleveland, OH 44113-3833 | 2020-11-04 |
| 1285235697 | Tennie E Millhouse | Home Health | 12808 Summerland Ave, Cleveland, OH 44111-5167 | 2020-11-03 |
| 1619578275 | Steps To Wellness, Inc. | Counselor | 3577 East 144h Street, Cleveland, OH 44120 | 2020-11-02 |
| 1295335800 | Blake Stuckey | Social Worker | 1750 Ansel Rd Apt 511, Cleveland, OH 44106-4103 | 2020-11-01 |
| 1396345989 | Kyle Johnston | Peer Specialist | 10525 Clifton Blvd Apt 3, Cleveland, OH 44102-1586 | 2020-11-01 |
| 1083214886 | Prestige Providers LLC | Home Health | 4500 Lee Rd Ste 232, Cleveland, OH 44128-2961 | 2020-10-30 |
| Find all providers in CLEVELAND | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336314038 | Jimmie L Smith | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 18350 E Highway 105 Ste A, Cleveland, TX 77328-2440 | 2008-04-24 |
| 1740349208 | Rose-mary, The Johanna Grasselli Rehabilitation and Education Center | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2346 W 14th St, Cleveland, OH 44113-3613 | 2006-12-08 |
| 1285750174 | Rha Health Services Nc, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 211 Roseman Ln, Cleveland, NC 27013-9473 | 2007-03-22 |
| 1457477317 | Rha Health Services Nc, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 211 Roseman Ln, Cleveland, NC 27013-9473 | 2007-03-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306318423 | Tohatchi Area of Opportunity & Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1658 S Second St, Gallup, NM 87301-5817 | 2018-12-31 |
| 1437659638 | Tender Loving Care Homes LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 10213 Belnap Pl Nw, Albuquerque, NM 87114-4682 | 2018-02-15 |
| 1609382910 | Heartwell Services LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4123 Eubank Blvd Ne, Albuquerque, NM 87111-3421 | 2017-12-21 |
| 1255843330 | Janyce Wallace | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 7700 Ranchwood Dr Nw, Albuquerque, NM 87120-4020 | 2017-10-30 |
| 1033569074 | Sorinity Support Services, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 818 W Granada St, Espanola, NM 87532-2409 | 2016-06-21 |
| 1629490263 | Aspire Developmental Services, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2603 W 25th St, Roswell, NM 88201-8878 | 2014-01-16 |
| 1548693203 | Hope Developmental Services, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1101 S Main St Ste B, Roswell, NM 88203-5614 | 2013-08-16 |
| 1861839235 | Angela Chavez | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 607 S Lea Ave, Roswell, NM 88203-4567 | 2013-05-26 |
| 1538444625 | Milagro De Vida Community Services LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2249 Santa Ana, Las Cruces, NM 88011-9082 | 2011-10-20 |
| 1255636221 | Onyx Supportive Living LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5301 Crooked Creek Ave Nw, Albuquerque, NM 87114-4193 | 2011-01-21 |
| Find all providers with the same taxonomy | ||||
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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.