CRESTWOOD BEHAVIORAL HEALTH, INC. (NPI# 1720165368) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1720165368 |
Entity Type | Organization |
Organization Name | CRESTWOOD BEHAVIORAL HEALTH, INC. |
Other Organization Name | FRUITRIDGE TRANSITIONAL HOME |
Practice Address |
4256 Fruitridge Rd Sacramento CA 95820-5047 |
Mailing Address |
7590 Shoreline Dr Stockton CA 95219-5455 |
Practice Telephone | 9164272363 |
Practice Fax Number | 9164292631 |
Mailing Telephone | 2099552328 |
Mailing Fax Number | 2099525314 |
Enumeration Date | 2006-11-01 |
Last Update Date | 2020-08-22 |
Authorized Official Name | MR. LORI BLACKBURN (VICE PRESIDENT) |
Authorized Official Telephone | 2099552322 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities |
Other Name | Type Code |
---|---|
FRUITRIDGE TRANSITIONAL HOME | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1487282273 | Crestwood Behavioral Health, Inc. | Intermediate Care Facility, Mental Illness | 303 S C St, Lompoc, CA 93436-7305 | 2020-03-29 |
1023495181 | Crestwood Behavioral Health, Inc. | Intermediate Care Facility, Mental Illness | 960 Third Ave, Chula Vista, CA 91911 | 2015-04-28 |
1295146934 | Crestwood Behavioral Health, Inc. | Intermediate Care Facility, Mental Illness | 5550 University Ave Ste A, San Diego, CA 92105 | 2014-05-15 |
1780009142 | Crestwood Behavioral Health, Inc. | Psychiatric Hospital | 2201 Tuolumne St Ste B, Vallejo, CA 94589-2524 | 2014-02-21 |
1669734075 | Crestwood Behavioral Health, Inc. | Psychiatric Hospital | 2600 Stockton Blvd Ste B, Sacramento, CA 95817-2210 | 2012-06-12 |
1194034645 | Crestwood Behavioral Health, Inc. | Psychiatric Hospital | 6700 Eucalyptus Dr Ste C, Bakersfield, CA 93306-6075 | 2010-10-01 |
1821269093 | Crestwood Behavioral Health, Inc. | Psychiatric Hospital | 6700 Eucalyptus Dr, Suite B, Bakersfield, CA 93306-6075 | 2008-03-17 |
1275668840 | Crestwood Behavioral Health, Inc. | Clinic/Center | 409 N Adams St, Dixon, CA 95620-2925 | 2007-02-22 |
1073648747 | Crestwood Behavioral Health, Inc. | Clinic/Center | 1945 Kidder Ave, Fairfield, CA 94533-3919 | 2007-02-22 |
1356411656 | Crestwood Behavioral Health, Inc. | Intermediate Care Facility, Mental Illness | 2600 Stockton Blvd, Sacramento, CA 95817-2210 | 2006-11-08 |
Street Address |
4256 FRUITRIDGE RD |
City | SACRAMENTO |
State | CA |
Zip Code | 95820-5047 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477846012 | Crestwood Behavioral Health, Inc. | Community Based Residential Treatment Facility, Mental Illness | 4256 Fruitridge Rd, Sacramento, CA 95820-5047 | 2011-05-16 |
1194985549 | Vernon Frayna | Counselor | 4256 Fruitridge Rd, Sacramento, CA 95820-5047 | 2008-06-10 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1629676820 | Laraine K Koen | Student in an Organized Health Care Education/Training Program | 123 Brookshire Lane, Sacramento, CA 95820 | 2020-10-12 |
1730737727 | Vincent Tang | Student in an Organized Health Care Education/Training Program | 3230 Sher Court, Sacramento, CA 95820 | 2019-09-03 |
1871159897 | Lauren Smith | Student in an Organized Health Care Education/Training Program | Department of Pediatrics Uc Davis Children's Hospital, 3671 Business Dr. Suite #110, Sacramento, CA 95820 | 2019-05-15 |
1053899336 | Melissa Anne Jeffery | Community Health Worker | 4600 Broadway Suite 1300, Sacramento, CA 95820 | 2018-07-30 |
1841785284 | Chelsea Kirstin Acker | Student in an Organized Health Care Education/Training Program | 3671 Business Dr., Sacramento, CA 95820 | 2018-06-28 |
1770022667 | Shelly Valdez | Behavior Technician | 5520 Priscilla Ln, Sacramento, CA 95820 | 2017-02-13 |
1285184135 | Trang Thu Tran | Registered Nurse | 5385 Franklin Blvd Ste A-d, Sacramento, CA 95820 | 2016-10-04 |
1356716039 | Nicole Hisaka | Psychologist | 3651 Business Dr, Sacramento, CA 95820 | 2015-12-07 |
1538542469 | Universal Med Express, LLC | Non-emergency Medical Transport (VAN) | 3230 27th Ave, Sacramento, CA 95820 | 2015-07-09 |
1033507470 | Moua Yang | Case Manager/Care Coordinator | 7373 14th Ave, Suite 120-b, Sacramento, CA 95820 | 2015-01-08 |
Find all providers in zip 95820 |
Taxonomy Code | 320800000X |
Grouping | Residential Treatment Facilities |
Classification | Community Based Residential Treatment Facility, Mental Illness |
A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1275178493 | Compassion Valley LLC | Community Based Residential Treatment Facility, Mental Illness | 6110 Garfield Ave, Sacramento, CA 95841-2009 | 2019-11-12 |
1376199232 | Psynergy Programs, Inc. | Community Based Residential Treatment Facility, Mental Illness | 9847 Folsom Blvd, Sacramento, CA 95827-1328 | 2019-08-15 |
1497926505 | Gifted Healing Center Inc | Community Based Residential Treatment Facility, Mental Illness | 2251 Florin Rd Ste 133, 7654 22nd Street House of Umoja/rafa Porject, Sacramento, CA 95822-4491 | 2008-03-17 |
1033318878 | Turning Point Community Programs | Community Based Residential Treatment Facility, Mental Illness | 5550 Meadow Park Way, Sacramento, CA 95823-5117 | 2007-07-12 |
1689876955 | Transit and Living & Community Support | Community Based Residential Treatment Facility, Mental Illness | 1816 O St, Sacramento, CA 95814-6194 | 2007-05-31 |
1548389364 | St. Therese's Haven | Community Based Residential Treatment Facility, Mental Illness | 7940 Golden Field Way, Sacramento, CA 95823-5209 | 2007-03-29 |
1164540381 | G Street House Board & Care, Inc | Community Based Residential Treatment Facility, Mental Illness | 1700 G St, Sacramento, CA 95814-2119 | 2007-03-26 |
1922176981 | Turning Point Crisis Residential Program | Community Based Residential Treatment Facility, Mental Illness | 4801 34th St, Sacramento, CA 95820-4849 | 2006-11-30 |
1821105115 | Famille/famille, Inc | Community Based Residential Treatment Facility, Mental Illness | 6431 Hogan Dr, Sacramento, CA 95822-3840 | 2006-08-24 |
1063034130 | Turning Point Community Programs | Community Based Residential Treatment Facility, Mental Illness | 3440 Viking Dr, Sacramento, CA 95827-2844 | 2020-05-12 |
Find all providers in SACRAMENTO |
City | SACRAMENTO |
Zip Code | 95820 |
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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.