THE PARENT COOPERATIVE COMMUNITY (NPI# 1578003711) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578003711 |
| Entity Type | Organization |
| Organization Name | THE PARENT COOPERATIVE COMMUNITY |
| Practice Address |
4426 Illinois Ave Fair Oaks CA 95628-6307 |
| Practice Telephone | 9169655135 |
| Practice Fax Number | 9169470371 |
| Mailing Telephone | 9169655135 |
| Mailing Fax Number | 9169470371 |
| Enumeration Date | 2017-03-07 |
| Last Update Date | 2017-03-07 |
| Authorized Official Name | MS. CARLA DEROSE (DIRECTOR) |
| Authorized Official Telephone | 9169655135 |
| Authorized Official Credential | MA, MFT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | 347004337 | CA | Residential Treatment Facilities |
| Street Address |
4426 ILLINOIS AVE |
| City | FAIR OAKS |
| State | CA |
| Zip Code | 95628-6307 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184103590 | Nora's Home Care, Inc | Assisted Living Facility | 5813 Kenneth Ave, Fair Oaks, CA 95628 | 2018-08-08 |
| 1124545512 | Shelby Matthews | Behavior Technician | 7712 Magnolia Ave, Fair Oaks, CA 95628 | 2017-08-25 |
| 1386166908 | Harcourt Bridges, LLC | Counselor | 4112 Crestline Ave Ste. B, Fair Oaks, CA 95628 | 2017-07-14 |
| 1063934867 | Harcourt Bridges, LLC | Counselor | 4112 Crestline Ave Ste. A, Fair Oaks, CA 95628 | 2017-07-13 |
| 1467986075 | Shelby Bryeans | Behavior Technician | 7949 California Ave Ste 15, Fair Oaks, CA 95628 | 2017-04-20 |
| 1942698790 | Life Span Home, Inc | Home Health | 4041 Bridge Street, Fair Oaks, CA 95628 | 2015-01-02 |
| 1861808008 | Edward John Olson | Social Worker | 5213 Vista Del Oro Way, Fair Oaks, CA 95628 | 2014-07-09 |
| 1073924643 | Frank Gontarski | Dentist | 4363 Hazel Avenue, Suite 6, Fair Oaks, CA 95628 | 2014-05-16 |
| 1801232921 | Lisa Hitomi | Community Health Worker | 9915 Fair Oaks Blvd, Fair Oaks, CA 95628 | 2013-05-15 |
| 1972842375 | Nicole Diana Cable | Marriage & Family Therapist | 10217 Fair Oaks Blvd, Suite A, Fair Oaks, CA 95628 | 2013-02-05 |
| Find all providers in zip 95628 | ||||
| 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 |
|---|---|---|---|---|
| 1730383340 | Paradise Oaks Youth Services | Residential Treatment Facility, Emotionally Disturbed Children | 8301 Olive Hill Ct, Fair Oaks, CA 95628-2630 | 2007-06-14 |
| 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 |
| 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.