Provider Demographics
NPI:1053827931
Name:CAMERON YOUTH HOME FACILITIES, INCORPORATED
Entity Type:Organization
Organization Name:CAMERON YOUTH HOME FACILITIES, INCORPORATED
Other - Org Name:CAMERON YOUTH HOME FACILITIES, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:WINSTON-WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-706-0627
Mailing Address - Street 1:PO BOX 11354
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93389-1354
Mailing Address - Country:US
Mailing Address - Phone:661-663-0898
Mailing Address - Fax:661-589-2912
Practice Address - Street 1:12010 ROARING RIVER AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-9308
Practice Address - Country:US
Practice Address - Phone:661-663-0898
Practice Address - Fax:661-589-2912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-14
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA157806044322D00000X
CA157804733322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children