PEPPERMINT RIDGE (NPI# 1689896813) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689896813 |
| Entity Type | Organization |
| Organization Name | PEPPERMINT RIDGE |
| Practice Address |
779 Ford Street Corona CA 92879-2507 |
| Mailing Address |
825 Magnolia Ave Corona CA 92879-3129 |
| Practice Telephone | 3512737320 |
| Practice Fax Number | 9517370726 |
| Mailing Telephone | 3512737320 |
| 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 | GARRISON HOUSE | LTC60245F | 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 |
| 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 |
779 FORD STREET |
| City | CORONA |
| State | CA |
| Zip Code | 92879-2507 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609475722 | Tahmea Henderson | Behavior Technician | 225 Rincon St. #219, Corona, CA 92879 | 2020-10-20 |
| 1669084828 | Kimberly O Harris | Behavioral Analyst | 225 E. Rincon St., Suite 219, Corona, CA 92879 | 2020-08-19 |
| 1962014381 | Mario Javier Herrera | Nurse Practitioner | 2130 High Pointe Dr, Apt 108, Corona, CA 92879 | 2020-08-18 |
| 1841659117 | Sleep & Cpap Center Inc | Clinical Medical Laboratory | 800 Magnolia Avenue, Suite 101, Corona, CA 92879 | 2016-02-16 |
| 1497151203 | Rafik Riad | Dentist | 817 Villa Montes Cir., Corona, CA 92879 | 2014-11-06 |
| 1326441551 | Ying Zhang Howe | Acupuncturist | 720 Magnolia Ave. #b3, Corona, CA 92879 | 2014-10-02 |
| 1164823233 | Piyush Sakhareliya | Pharmacist | 2230 Treemont Pl, Apt#207, Corona, CA 92879 | 2014-09-09 |
| 1053711739 | Brandice Medical Associates Inc | Clinical Medical Laboratory | 13575 Jasper Loop, Corona, CA 92879 | 2014-08-29 |
| 1982956058 | Nja Therapy Services, Inc. | Day Training, Developmentally Disabled Services | 1655 E 6th St Suite 204, Corona, CA 92879 | 2012-10-12 |
| 1356616064 | Corona Surgical LLC | Clinic/Center | 2370 Anselmo Drive, Corona, CA 92879 | 2012-03-13 |
| Find all providers in zip 92879 | ||||
| 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 |
| 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.