MERRILL COMMUNITY SERV INC (NPI# 1962699751) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962699751 |
| Entity Type | Organization |
| Organization Name | MERRILL COMMUNITY SERV INC |
| Practice Address |
9161 Sierra Ave Suite 200 Fontana CA 92335-4729 |
| Practice Telephone | 9098230609 |
| Practice Fax Number | 9098234187 |
| Mailing Telephone | 9098230609 |
| Mailing Fax Number | 9098234187 |
| Enumeration Date | 2007-09-26 |
| Last Update Date | 2009-03-03 |
| Authorized Official Name | MR. WARREN DEAVON BATISTE (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 9098230609 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | 360016AN | CA | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MED I CAL | 363648 | 01 |
| Street Address |
9161 SIERRA AVE SUITE 200 |
| City | FONTANA |
| State | CA |
| Zip Code | 92335-4729 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982607461 | Durban Investment Inc. | Home Health | 9161 Sierra Ave, Ste 201a, Fontana, CA 92335-4773 | 2005-05-27 |
| 1447705538 | New Life Rehab and Acupuncture, Inc | Clinic/Center | 9161 Sierra Ave, Fontana, CA 92335-4729 | 2016-08-18 |
| 1518375393 | Family Service Agency of San Bernardino | Community/Behavioral Health | 9161 Sierra Ave, Suite 212, Fontana, CA 92335-4729 | 2014-07-24 |
| 1003183237 | Kanddid Health Care Inc | Home Health | 9161 Sierra Ave, Suite 200, Fontana, CA 92335-4729 | 2011-11-16 |
| 1790088094 | Ashley Benz Trino | Physical Therapist | 9161 Sierra Ave, Suite 211, Fontana, CA 92335-4729 | 2010-12-09 |
| 1851535413 | Michelle Lara Kim | Specialist | 9161 Sierra Ave, Suite 111, Fontana, CA 92335-4729 | 2009-04-27 |
| 1386812170 | Carol Rose Adkisson | Counselor | 9161 Sierra Ave, Suite 201-c, Fontana, CA 92335-4729 | 2008-02-14 |
| 1174704324 | Mark Hidalgo Gabot | Nurse Anesthetist, Certified Registered | 9161 Sierra Ave, Fontana, CA 92335-4729 | 2007-11-15 |
| 1528255320 | Kitchie Ramos Miana | Dietitian, Registered | 9161 Sierra Ave, Fontana, CA 92335-4729 | 2007-09-26 |
| 1699961383 | Judy E. Bush | Occupational Therapist | 9161 Sierra Ave, Fontana, CA 92335-4729 | 2007-09-17 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104425131 | Hossein Malakooti A Dental Corporation | Clinic/Center | 16540 Merrill Ave, Fontana, CA 92335 | 2020-10-21 |
| 1790312791 | Trevor Nguyen | Student in an Organized Health Care Education/Training Program | 17234 Valley Blvd, Building A, Fontana, CA 92335 | 2020-03-27 |
| 1184251365 | Benjamin Chang | Student in an Organized Health Care Education/Training Program | 17234 Valley Blvd., Bldg. A, Fontana, CA 92335 | 2020-03-26 |
| 1407487309 | Perla Hernandez | Licensed Vocational Nurse | 14677 Merrill Aver, Fontana, CA 92335 | 2020-01-29 |
| 1013552660 | Valencia Malone | Licensed Vocational Nurse | 14677 Merrill, Fontana, CA 92335 | 2019-11-07 |
| 1831749779 | Daniel Eric Wright | Student in an Organized Health Care Education/Training Program | 14677 Merrell Ave., Fontana, CA 92335 | 2019-09-12 |
| 1962069815 | Melissa Rivera | Licensed Vocational Nurse | 15217 San Bernardino Ave., Fontana, CA 92335 | 2019-05-28 |
| 1275199770 | Jennifer Lynn Malone | Peer Specialist | 14677 Merrall Ave, Fontana, CA 92335 | 2019-05-10 |
| 1770147894 | Noelle Chong | Registered Nurse | 14677 Merill Ave, Fontana, CA 92335 | 2019-04-24 |
| 1992261929 | Destiny Alzate | Counselor | 1467 Merrill Ave, Fontana, CA 92335 | 2019-02-14 |
| Find all providers in zip 92335 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821618844 | Berhe Group Home Inc. | Community/Behavioral Health | 9836 Mango Ln, Fontana, CA 92335-6790 | 2020-04-20 |
| 1821618836 | Berhe Group Home Inc. | Community/Behavioral Health | 17187 Hawthorne Ave, Fontana, CA 92335-5826 | 2020-04-20 |
| 1972123230 | Berhe Group Home Inc. | Community/Behavioral Health | 9034 Chantry Ave, Fontana, CA 92335-4613 | 2020-04-16 |
| 1538672878 | Family Service Association | Community/Behavioral Health | 17210 Slover Ave Ste 200, Fontana, CA 92337-7536 | 2017-11-08 |
| 1881073856 | Behavior Analysts International, LLC. | Community/Behavioral Health | 6871 San Rafael Ct, Fontana, CA 92336-5064 | 2015-05-24 |
| 1033320940 | County of San Bernardino | Community/Behavioral Health | 17053 E. Foothill Blvd., Building B, Fontana, CA 92335 | 2007-05-24 |
| 1619195740 | Water of Life Community Outreach | Community/Behavioral Health | 7623 East Ave, Fontana, CA 92336-2901 | 2007-04-23 |
| 1518375393 | Family Service Agency of San Bernardino | Community/Behavioral Health | 9161 Sierra Ave, Suite 212, Fontana, CA 92335-4729 | 2014-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740881861 | Griselda Tuchan Pineda Marriage and Family Therapist Inc | Community/Behavioral Health | 2820 S Vermont Ave Ste 16, Los Angeles, CA 90007-2291 | 2020-11-04 |
| 1013518687 | Turning Point of Central California, Inc. | Community/Behavioral Health | 3636 N 1st St Ste 112, Fresno, CA 93726-6818 | 2020-11-02 |
| 1588264113 | Licensed Clinical Social Worker Community Alliance PC | Community/Behavioral Health | 301 S 23rd St, Richmond, CA 94804-2807 | 2020-11-01 |
| 1134729718 | Cynthia Felicia Delaney | Community/Behavioral Health | 4887 Bella Pacific Row Unit 240, San Diego, CA 92109-8515 | 2020-10-31 |
| 1114527637 | Clarke-lauren Stevenson Richard | Community/Behavioral Health | 1277 E Loma Linda Ave, Fresno, CA 93720-2668 | 2020-10-26 |
| 1891395232 | Jacqulyn Danielle Rios | Community/Behavioral Health | 4604 W Douglas Ave Apt 103, Visalia, CA 93291-4195 | 2020-10-26 |
| 1346849213 | Greystone Behavioral Health Nursing Inc | Community/Behavioral Health | 231 E Alessandro Blvd Ste A438, Riverside, CA 92508-5084 | 2020-10-22 |
| 1376142216 | Melissa Reyes Aguilar | Community/Behavioral Health | 2248 S Cochran Ave, Los Angeles, CA 90016-1218 | 2020-10-21 |
| 1578162616 | Bayfront Healthcare Services | Community/Behavioral Health | 2703 N Studebaker Rd, Long Beach, CA 90815-1628 | 2020-10-20 |
| 1326647686 | Sierra Child & Family Services | Community/Behavioral Health | 564 Mountain Ranch Rd Ste 5, San Andreas, CA 95249-9782 | 2020-10-19 |
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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.