Peppermint Ridge in Corona - Residential Treatment Facility, Intellectual And/or Developmental Disabilities
Peppermint Ridge - NPI 1063634541
Peppermint Ridge is a Residential Treatment Facility, Intellectual And/or Developmental Disabilities in Corona, California. Peppermint Ridge practices all healthcare services and medical treatments related to Residential Treatment Facility, Intellectual And/or Developmental Disabilities. The NPI Number for Peppermint Ridge is 1063634541. The last update date is 2020-08-22.
Peppermint Ridge's current location address is 825 Magnolia Ave, Corona, California. You can contact this provider via phone number 9512737320 and fax number 9517370726. The mailing address for Peppermint Ridge is 825 Magnolia Ave, Corona, California. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Peppermint Ridge |
|---|---|
| Address | 825 Magnolia Ave, Corona, California |
| Phone Number | 9512737320 |
| Fax Number | 9517370726 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | EXECUTIVE |
|---|---|
| Authorized Official Name | Garrett A. John |
| Credentials | M.S.W. |
| Telephone Number | 9512737320 |
NPI Number Detail
| NPI Number | 1063634541 |
|---|---|
| Provider Enumeration Date | 2007-05-03 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 825 Magnolia Ave |
|---|---|
| City | Corona |
| State | California (CA) |
| Post Code | 928793129 |
| Phone Number | 9512737320 |
| Fax Number | 9517370726 |
Provider's Primary Taxonomy Detail
| Speciality | Residential Treatment Facility, Intellectual And/or Developmental Disabilities |
|---|---|
| Taxonomy | 320600000X |
|
Definition: A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| LTC80322F | CA | ROGER RESIDENCE |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Peppermint Ridge by the Centers for Medicare & Medicaid Services?
The Peppermint Ridge has been assigned the NPI (National Provider Identifier) 1063634541 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you provide the complete physical address where Peppermint Ridge is located?
The Peppermint Ridge is situated at the following address: 825 Magnolia Ave, Corona, CA, 928793129.
What is Peppermint Ridge's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Peppermint Ridge is Residential Treatment Facility, Intellectual And/or Developmental Disabilities, and the taxonomy classification code that categorizes this area of expertise is 320600000X.
When did the Peppermint Ridge receive its 1063634541?
The Peppermint Ridge was issued its 1063634541 on 2007-05-03, which is the date when the organization was assigned this unique identifier.
As of what date were the details pertaining to Peppermint Ridge last refreshed?
The information related to the Peppermint Ridge, including its address, specialty, and other relevant details, was last updated on 2020-08-22.
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