Organization · Type 2 NPI

Fields Comp. Youth Services Inc.

Emotionally Disturbed Childrens' Residential Treatment Facility · San Bernardino, CA

NPI number 1295514149 Active

Practice location

2390 Portola St
San Bernardino, CA 92407-6930

Call (909) 376-4148 Map

Mailing address

8780 19th St # 196
Alta Loma, CA 91701-4608

Specialties and licenses

Taxonomy	Code	License
Emotionally Disturbed Childrens' Residential Treatment Facility Primary	322D00000X	None listed

Emotionally Disturbed Childrens' Residential Treatment Facility: A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.

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NPI record

NPI: 1295514149
Entity type: Organization (Type 2)
Issued: Sep 28, 2023
Last updated: Sep 28, 2023
Status: Active
Subpart: Yes of Fields Comp. Youth Services Inc.

Other names

Fields Comprehensive Youth Services Inc III · other name

Authorized official

Arby Enrico Fields
Executive Director
(909) 322-6980

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1295514149

Fields Comp. Youth Services Inc.'s National Provider Identifier is 1295514149, issued on Sep 28, 2023. The primary taxonomy on file is Emotionally Disturbed Childrens' Residential Treatment Facility (322D00000X), and the practice location is in San Bernardino, CA. The record was last updated on Sep 28, 2023.