MEDICARE: DOWNS & MARTIN CHILDREN'S SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	322D00000X	Emotionally Disturbed Childrens' Residential Treatment Facility

General Provider Information

NPI Number	:	1134952344
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOWNS & MARTIN CHILDREN'S SERVICES

Provider Business Mailing Address
First Line	:	4870 LUTHER ST
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92504-2245
Country	:	US
Telephone Number	:	909-910-9502
Fax Number	:

Provider Business Practice Location Address
First Line	:	4870 & 4872 LUTHER ST
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92504-2245
Country	:	US
Telephone Number	:	951-742-5143
Fax Number	:

Authorized Official
Title or Position	:	EXE. DIRECTOR
Name	:	MR. EMMETT DOWNS
Credential	:	AMFT
Telephone Number	:	909-910-9502

Provider Enumeration Date	:	08/22/2024
Last Update Date	:	02/19/2025

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