G & C SWAN INC (NPI# 1740569235) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740569235 |
| Entity Type | Organization |
| Organization Name | G & C SWAN INC |
| Other Organization Name | NEW CREATION ADDICTION TREATMENT CENTER |
| Practice Address |
23950 Prado Ln Colton CA 92324-9734 |
| Mailing Address |
9491 Pittsburgh Ave Rancho Cucamonga CA 91730-9022 |
| Practice Telephone | 9095141958 |
| Mailing Telephone | 9094762023 |
| Enumeration Date | 2011-08-15 |
| Last Update Date | 2020-04-22 |
| Authorized Official Name | MS. CAROL LYNN SWANSON (CFO) |
| Authorized Official Telephone | 9099816121 |
| Authorized Official Credential | BS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | 360075AP | CA | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| His House | Doing Business As Name - Organization |
| New Creation Addiction Treatment Center | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 11646 Encanto Ln, Colton, CA 923249218 | 9095141958 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174931794 | G & C Swan Inc | Substance Abuse Rehabilitation Facility | 563 N Central Ave, Upland, CA 91786-4241 | 2014-07-28 |
| 1659662351 | G & C Swan Inc | Substance Abuse Rehabilitation Facility | 239 W 9th St, Upland, CA 91786-5979 | 2011-04-28 |
| 1649449554 | G & C Swan Inc | Substance Abuse Rehabilitation Facility | 120 W 9th St, T-3, Upland, CA 91786-5907 | 2008-02-25 |
| 1952885139 | G & C Swan Inc | Substance Abuse Rehabilitation Facility | 11646 Encanto Ln, Colton, CA 92324-9218 | 2018-09-24 |
| 1497132765 | G & C Swan Inc | Substance Abuse Rehabilitation Facility | 9491 Pittsburgh Ave, Rancho Cucamonga, CA 91730-9022 | 2015-05-06 |
| Street Address |
23950 PRADO LN |
| City | COLTON |
| State | CA |
| Zip Code | 92324-9734 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952593089 | Patricia Owens | Counselor | 23950 Prado Ln, Colton, CA 92324-9734 | 2007-08-13 |
| 1255931069 | Andrea Dawson-horan | Counselor | 23950 Prado Ln, Colton, CA 92324-9734 | 2020-10-30 |
| 1972115814 | Lisa Higgins | Counselor | 23950 Prado Ln, Colton, CA 92324-9734 | 2020-08-21 |
| 1073121059 | Vincent Arias | Counselor | 23950 Prado Ln, Colton, CA 92324-9734 | 2020-07-16 |
| 1073138079 | Jonita Simpkins | Counselor | 23950 Prado Ln, Colton, CA 92324-9734 | 2020-06-15 |
| 1528682390 | Candyce S Jackson | Counselor | 23950 Prado Ln, Colton, CA 92324-9734 | 2020-06-08 |
| 1013531078 | Nicole Shaver | Counselor | 23950 Prado Ln, Colton, CA 92324-9734 | 2020-06-04 |
| 1831712827 | Yvonne Louise Mccormick | Counselor | 23950 Prado Ln, Colton, CA 92324-9734 | 2020-05-25 |
| 1780205682 | Sulma Karina Camargo | Counselor | 23950 Prado Ln, Colton, CA 92324-9734 | 2020-05-01 |
| 1184244626 | Dan'l Benton | Counselor | 23950 Prado Ln, Colton, CA 92324-9734 | 2020-04-24 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134739949 | Ava Vascular | Radiology | 1281 W. C. Street, Suite 200, Colton, CA 92324 | 2020-08-06 |
| 1063042851 | Making A Difference Association, Inc. | Psychologist | 1430 E Cooley Drive, Ste 111, Colton, CA 92324 | 2020-01-21 |
| 1326685488 | Allstar Medical Respite and Recuperative Care | Case Management | 450 N Sperry Drive, Colton, CA 92324 | 2019-12-06 |
| 1558916379 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 1010 North Pepper Ave, Colton, CA 92324 | 2019-08-08 |
| 1326692633 | Kadi Lyn Pearce | Licensed Practical Nurse | 970 N. Latham St, Colton, CA 92324 | 2019-07-25 |
| 1184281966 | Steven Andrew Cardoza | Physician Assistant | Armc, 400 N. Pepper Ave, Colton, CA 92324 | 2019-05-28 |
| 1528540952 | Daniel Tochukwu Umah-mgborogwu | Physician Assistant | 400 N Pepper Ave, Ste 107, Coton, CA 92324 | 2018-09-01 |
| 1255826038 | Cal Med Vascular Center LLC | Clinic/Center | 1281 W C St, Colton, CA 92324 | 2018-06-25 |
| 1891288072 | A. Arroyo Lourenco Dds, Inc | Dentist | 827 W Valley Blvd., Colton, CA 92324 | 2018-06-12 |
| 1700396165 | Emily Covington | Registered Nurse | 1550 E. Washington St., Ste 101, Colton, CA 92324 | 2017-10-11 |
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| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053730937 | New Creation Behavioral Healthcare Foundation | Substance Abuse Rehabilitation Facility | 2511 S Mccarty Dr, Colton, CA 92324-9220 | 2014-04-08 |
| 1952885139 | G & C Swan Inc | Substance Abuse Rehabilitation Facility | 11646 Encanto Ln, Colton, CA 92324-9218 | 2018-09-24 |
| 1649433236 | Cvrrc, Mhs, Inc | Substance Abuse Rehabilitation Facility | 1076 Santo Antonio Dr, Colton, CA 92324-8103 | 2008-07-03 |
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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.