MOUNTAIN HEALTH & COMMUNITY SERVICES, INC. (NPI# 1982658142) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982658142 |
| Entity Type | Organization |
| Organization Name | MOUNTAIN HEALTH & COMMUNITY SERVICES, INC. |
| Practice Address |
1388 Buckman Springs Rd Campo CA 91906-2028 |
| Mailing Address |
31115 Highway 94 Campo CA 91906-3133 |
| Practice Telephone | 6194785254 |
| Practice Fax Number | 6194789164 |
| Mailing Telephone | 6194785254 |
| Mailing Fax Number | 6194789164 |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2020-02-07 |
| Authorized Official Name | JUDITH SHAPLIN (CEO) |
| Authorized Official Telephone | 6194456200 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | CLIA NUMBER | 05D0671660 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245893072 | Mountain Health & Community Services, Inc. | Clinic/Center | 4440 Euclid Ave Ste C, San Diego, CA 92115-4522 | 2019-04-17 |
| 1336592740 | Mountain Health & Community Services, Inc. | Clinic/Center | 1388 Buckman Springs Road, Campo, CA 91906 | 2016-07-20 |
| 1326229477 | Mountain Health & Community Services, Inc. | Clinic/Center | 3291 Buckman Springs Rd, Pine Valley, CA 91962-4003 | 2007-11-16 |
| 1063613263 | Mountain Health & Community Services, Inc. | Clinic/Center | 255 N Ash St Ste 101, Escondido, CA 92027-3069 | 2007-05-29 |
| 1861603151 | Mountain Health & Community Services, Inc. | Clinic/Center | 316 25th St, San Diego, CA 92102-3016 | 2007-05-25 |
| 1255499075 | Mountain Health & Community Services, Inc. | Clinic/Center | 1620 Alpine Blvd Ste 110, Alpine, CA 91901-1103 | 2006-12-05 |
| 1740358258 | Mountain Health & Community Services, Inc. | Clinic/Center | 44460 Old Hwy 80, Jacumba, CA 91934 | 2006-12-01 |
| 1487011847 | Mountain Health & Community Services, Inc. | Clinic/Center | 4690 El Cajon Blvd, San Diego, CA 92115-4403 | 2016-01-15 |
| 1881752608 | Mountain Health & Community Services, Inc. | Clinic/Center | 31115 Highway 94, Campo, CA 91906-3133 | 2006-12-05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Mountain Health & Community Services, Inc | 1388 Buckman Springs Road, Campo, CA 91906 |
| Street Address |
1388 BUCKMAN SPRINGS RD |
| City | CAMPO |
| State | CA |
| Zip Code | 91906-2028 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174164719 | Centro De Salud De La Comunidad De San Ysidro, Inc. | Clinic/Center | 1388 Buckman Springs Rd, Campo, CA 91906-2028 | 2019-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316424351 | Jr Ranch | Substance Abuse Rehabilitation Facility | 1765 Buckman Springs Rd, Campo, CA 91906 | 2018-07-23 |
| 1336592740 | Mountain Health & Community Services, Inc. | Clinic/Center | 1388 Buckman Springs Road, Campo, CA 91906 | 2016-07-20 |
| 1932572385 | Joshua Knutson | Marriage & Family Therapist | 976 Sheridan Rd, Campo, CA 91906 | 2015-11-06 |
| 1093937591 | San Diego Freedom Ranch, Inc. | Substance Abuse Rehabilitation Facility | 1777 Buckman Springs Rd, Campo, CA 91906 | 2007-05-03 |
| 1760603740 | Linda Rae Anderson | Acupuncturist | 33446 Hwy 94, Campo, CA 91906 | 2007-05-01 |
| 1407887227 | Jay Mark Cool | Physician Assistant | 31115 Highway 94, Campo, CA 91906 | 2006-07-06 |
| 1518577493 | Billy Don Wilson | Counselor | 1777 Buckman Springs Rd, Campo, CA 91906-2022 | 2020-08-05 |
| 1043820202 | Marco Martinez | Counselor | 1777 Buckman Springs Rd, Campo, CA 91906-2022 | 2020-08-03 |
| 1831725779 | David M Pardue | Counselor | 1777 Buckman Springs Rd, Campo, CA 91906-2022 | 2020-03-22 |
| 1316505100 | Michael Derek Waters | Counselor | 1777 Buckman Springs Rd, Campo, CA 91906-2022 | 2019-06-05 |
| Find all providers in zip 91906 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336592740 | Mountain Health & Community Services, Inc. | Clinic/Center | 1388 Buckman Springs Road, Campo, CA 91906 | 2016-07-20 |
| 1174164719 | Centro De Salud De La Comunidad De San Ysidro, Inc. | Clinic/Center | 1388 Buckman Springs Rd, Campo, CA 91906-2028 | 2019-10-04 |
| 1881752608 | Mountain Health & Community Services, Inc. | Clinic/Center | 31115 Highway 94, Campo, CA 91906-3133 | 2006-12-05 |
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| 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.