Basic Information
| Provider Information | |||||||||
| NPI: | 1538688585 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PLAN-IT LIFE, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6235 RIVER CREST DR STE N | ||||||||
| Address2: | |||||||||
| City: | RIVERSIDE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 925070758 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9516537561 | ||||||||
| FaxNumber: | 9516537563 | ||||||||
| Practice Location | |||||||||
| Address1: | 5729 VISTA DEL CABALLERO | ||||||||
| Address2: | |||||||||
| City: | JURUPA VALLEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 925096423 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9517882972 | ||||||||
| FaxNumber: | 9517882374 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/11/2017 | ||||||||
| LastUpdateDate: | 08/30/2022 | ||||||||
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| AuthorizedOfficialLastName: | MCLEAN | ||||||||
| AuthorizedOfficialFirstName: | NYRON | ||||||||
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| AuthorizedOfficialTitleorPosition: | CHIEF FINANCIAL OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 9517427561 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 08/30/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251B00000X | 336407591 | CA | N | Agencies | Case Management | 251S00000X | 336407591 | CA | N | Agencies | Community/Behavioral Health | 253J00000X | 336407591 | CA | N | Agencies | Foster Care Agency | 261QM0801X | 336407591 | CA | N | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) | 322D00000X | 336407591 | CA | N | Residential Treatment Facilities | Residential Treatment Facility, Emotionally Disturbed Children | 323P00000X | 336407591 | CA | N | Residential Treatment Facilities | Psychiatric Residential Treatment Facility | 324500000X | 336407591 | CA | N | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility | 3245S0500X | 336407591 | CA | N | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility | Substance Abuse Treatment, Children | 320800000X | 336407591 | CA | Y | Residential Treatment Facilities | Community Based Residential Treatment Facility, Mental Illness |
No ID Information.