PARADISE ADOLESCENT HOME, INC. (NPI# 1902412182) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902412182 |
| Entity Type | Organization |
| Organization Name | PARADISE ADOLESCENT HOME, INC. |
| Practice Address |
136 Valdivia Cir San Ramon CA 94583-2228 |
| Mailing Address |
Po Box 626 San Ramon CA 94583-0626 |
| Practice Telephone | 9259010219 |
| Practice Fax Number | 9259011300 |
| Mailing Telephone | 9259010219 |
| Mailing Fax Number | 9259011300 |
| Enumeration Date | 2020-09-22 |
| Last Update Date | 2020-09-22 |
| Authorized Official Name | MARITZA JEFFERSON-GREGORY (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 9255708498 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740897784 | Paradise Adolescent Home, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 602 Woodlark Dr, Suisun City, CA 94585-2244 | 2020-09-24 |
| Street Address |
136 VALDIVIA CIR |
| City | SAN RAMON |
| State | CA |
| Zip Code | 94583-2228 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295375475 | Angel Beatrice Mckneely | Behavior Technician | 3150 Crow Canyon Place, Suite 110, San Ramon, CA 94583 | 2020-01-15 |
| 1205302247 | Asma Parisa Rezaye | Behavior Technician | 4708 Norris Canyon Rd, Unit 201, San Ramon, CA 94583 | 2018-10-17 |
| 1679055461 | Mary Martineau | Speech-Language Pathologist | 210 Porter Dr Ste 120, San Ramon, CA 94583 | 2018-08-29 |
| 1336631332 | Alison Jean Barnes | Behavior Technician | Goals for Autism, 1 Crow Canyon Court, San Ramon, CA 94583 | 2018-06-05 |
| 1730671975 | Michael Federico | Pharmacist | 2735 Ascot Drive, San Ramon, CA 94583 | 2018-06-04 |
| 1508384843 | Donor Network West | Organ Procurement Organization | 12667 Alcosta Blvd., Suite 500, San Ramon, CA 94583 | 2017-09-07 |
| 1265950141 | Danielle Lustig Fitch | Marriage & Family Therapist | 3180 Crown Canyon Pl. Ste 140, San Ramon, CA 94583 | 2017-08-31 |
| 1386166205 | Park Place Ambulatory Surgery Center | Orthopaedic Surgery | 100 Park Place, Suite 100, San Ramon, CA 94583 | 2017-07-12 |
| 1952822991 | Virginia Rutledge Mosby | Marriage & Family Therapist | 3180 Crow Canyon Place #140, San Ramon, CA 94583 | 2017-06-29 |
| 1437684784 | Nakhla Dental Group | Dentist | Crow Canyon Dental, 2821 Crow Canyon Road #200, San Ramon, CA 94583 | 2017-04-25 |
| Find all providers in zip 94583 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| 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 |
| 1174132807 | Harvest Safe Haven for Boys | Residential Treatment Facility, Emotionally Disturbed Children | 5425 Sierra Vista Ave, Riverside, CA 92505-3113 | 2020-07-28 |
| 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.