EXODUS RECOVERY CSC (NPI# 1851787188) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1851787188 |
Entity Type | Organization |
Organization Name | EXODUS RECOVERY CSC |
Practice Address |
4411 E Kings Canyon Rd Fresno CA 93702-3604 |
Practice Telephone | 5594531008 |
Practice Fax Number | 5594532805 |
Mailing Telephone | 5594531008 |
Mailing Fax Number | 5594532805 |
Enumeration Date | 2015-04-14 |
Last Update Date | 2015-04-14 |
Authorized Official Name | TONYA SHARP-RIVAS (PROGRAM DIRECTOR) |
Authorized Official Telephone | 5594531008 |
Authorized Official Credential | RN |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 273R00000X | Psychiatric Unit | 771162 | MN | Hospital Units |
Street Address |
4411 E KINGS CANYON RD |
City | FRESNO |
State | CA |
Zip Code | 93702-3604 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1649275132 | Marianne Elena Tur | Nurse Practitioner | 4411 E Kings Canyon Rd, Fresno, CA 93702 | 2005-06-20 |
1992304653 | Ronda Denise Lincoln | Registered Nurse | 4411 E Kings Canyon Rd, Fresno, CA 93702-3604 | 2020-10-22 |
1871100248 | Tanveer Hans | Licensed Psychiatric Technician | 4411 E Kings Canyon Rd, Fresno, CA 93702-3604 | 2020-09-29 |
1568079192 | Samantha Hagerman | Registered Nurse | 4411 E Kings Canyon Rd, Fresno, CA 93702-3604 | 2020-09-28 |
1952917130 | Aly Kelly Ly | Registered Nurse | 4411 E Kings Canyon Rd, Fresno, CA 93702-3604 | 2020-09-22 |
1144848615 | Jennifer Salinas | Licensed Vocational Nurse | 4411 E Kings Canyon Rd, Fresno, CA 93702-3604 | 2020-07-10 |
1144848052 | Amarvir Khroud | Registered Nurse | 4411 E Kings Canyon Rd, Fresno, CA 93702-3604 | 2020-07-07 |
1841818994 | Maria Lourdes Aguilar | Licensed Vocational Nurse | 4411 E Kings Canyon Rd, Fresno, CA 93702-3604 | 2020-07-06 |
1366069577 | Ulysses Ruvalcaba | Licensed Psychiatric Technician | 4411 E Kings Canyon Rd, Fresno, CA 93702-3604 | 2020-07-03 |
1013532316 | Nada Moua | Registered Nurse | 4411 E Kings Canyon Rd, Fresno, CA 93702-3604 | 2020-06-11 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1730644543 | Brandy Eugena Dickey | Licensed Vocational Nurse | 496 S. Barton St., Fresno, CA 93702 | 2019-02-06 |
1205308269 | Kelly Ramirez | Counselor | 496 S. Barton St, Fresno, CA 93702 | 2018-12-31 |
1518437995 | Kimberlin Ann Klein | Licensed Vocational Nurse | 4411 E Kings Canyon Rd #319, Fresno, CA 93702 | 2018-11-28 |
1932677317 | Simone Danielle Cato | Counselor | 496 S Barton St, Fresno, CA 93702 | 2018-11-05 |
1558879841 | Mekdes Elizabeth Yilma | Marriage & Family Therapist | 4144 E. Kings Canyon Rd., Fresno, CA 93702 | 2018-01-20 |
1831647874 | Rick Foster | Registered Nurse | 441 East Kings Canyon Ave, Fresno, CA 93702 | 2016-09-20 |
1770935140 | Diana L. Eaglin | Registered Nurse | 4409 E. Inyo St., Modular A, Fresno, CA 93702 | 2016-07-08 |
1700257243 | Elizabeth Lee | Registered Nurse | 4411 E.kings Canyon Rd, Fresno, CA 93702 | 2015-10-09 |
1548657299 | Brandi Lynn Rieux | Counselor | 496 S. Barton Ave, Fresno, CA 93702 | 2015-04-21 |
1891069548 | Tamara Taylor | Case Manager/Care Coordinator | 890 S. Tenth Street, Fresno, CA 93702 | 2012-02-28 |
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Taxonomy Code | 273R00000X |
Grouping | Hospital Units |
Classification | Psychiatric Unit |
In general, a distinct unit of a hospital that provides acute or long-term care to emotionally disturbed patients, including patients admitted for diagnosis and those admitted for treatment of psychiatric problems on the basis of physicians' orders and approved nursing care plans. Long-term care may include intensive supervision to the chronically mentally ill, mentally disordered or other mentally incompetent persons; (2) For Medicare, a distinct part of a general acute care hospital admitting only patients whose admission to the unit is required for active treatment, whose treatment is of an intensity that can be provided only in an inpatient hospital setting, and whose condition is described by a psychiatric principal diagnosis contained in the Third Edition of the American Psychiatric Association Diagnostic and Statistical Manual or in Chapter 5 (Mental Disorders) of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The unit must furnish, through the use of qualified personnel, psychological services, social work services, psychiatric nursing, occupational therapy, and recreational therapy. The unit must maintain medical records that permit determination of the degree and intensity of treatment provided to individuals who are furnished services in the unit; the unit must meet special staff requirements in that the unit must have adequate numbers of qualified professional and supportive staff to evaluate inpatients, formulate written, individualized, comprehensive treatment plans, provide active treatment measures and engage in discharge planning. |
Notes: Source: (1) AHA Annual Survey p. A10 1996 AHA Guide; (2) Code of Federal Regulations #42, Section 412.27. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1962566778 | Fresno County | Psychiatric Unit | 2029 E Sussex Way, 207, Fresno, CA 93726-3972 | 2006-12-19 |
1962656082 | Fresno Community Hospital and Medical Center | Psychiatric Unit | 7171 N Cedar Ave, Fresno, CA 93720-3311 | 2008-11-17 |
1700058047 | Department of Children and Family Services | Psychiatric Unit | 3133 N Millbrook Ave, Fresno, CA 93703-1425 | 2008-03-27 |
1053581108 | Department of Children and Family Services | Psychiatric Unit | 3133 N Millbrook Ave, Fresno, CA 93703-1425 | 2008-03-05 |
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1316416670 | Psychiatric Excellence | Psychiatric Unit | 388 Market St Ste 1300, San Francisco, CA 94111-5316 | 2018-11-16 |
1982192514 | Veronica E Martinez | Psychiatric Unit | 9481 Hanford St, Ventura, CA 93004-0704 | 2018-04-30 |
1679008817 | Ucla Semel Institute | Psychiatric Unit | 615 6th St, Davis, CA 95616-3807 | 2017-04-25 |
1083152748 | Rady Childrens Hospital-san Diego | Psychiatric Unit | 4305 University Avenue, Suite 150, San Diego, CA 92105 | 2017-02-02 |
1871045385 | Molina Psychological Consultants | Psychiatric Unit | 18 Monrovia, Irvine, CA 92602-0925 | 2016-10-31 |
1457808073 | Susan Mora | Psychiatric Unit | 1239 Powell St, Apt 2, San Francisco, CA 94133-4874 | 2016-09-01 |
1306204342 | County of Santa Clara | Psychiatric Unit | 820 Enborg Court, San Jose, CA 95128 | 2016-02-05 |
1477931673 | Nigthingale Nurses | Psychiatric Unit | 350 N Magnolia St, Woodlake, CA 93286-1320 | 2015-05-08 |
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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.