BLOOMINGTON PENTECOSTAL CHURCH OF GOD
NPI 1285598243
Case Manager/Care Coordinator in Lytle Creek, CA

Q: What is Bloomington Pentecostal Church Of God's specialty?

The primary specialty registered for this NPI is Case Manager/Care Coordinator with taxonomy code 171M00000X.

Active since December 15, 2025

585 LYTLE CREEK RD, LYTLE CREEK, CA 92358(909) 900-6011 Get Directions Write a Review

NPPES record last updated: December 15, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Bloomington Pentecostal Church Of God NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BLOOMINGTON PENTECOSTAL CHURCH OF GOD (NPI 1285598243) is a healthcare organization registered as a case manager/care coordinator in Lytle Creek, California and active in the NPI registry since December 2025. The organization lists John Deatherage, Pastor, as its authorized official.

NPPES Registry Identity

NPI1285598243

Entity TypeOrganization

Primary Taxonomy171M00000X

Legal Business NameBLOOMINGTON PENTECOSTAL CHURCH OF GOD

Location Address585 LYTLE CREEK RDLytle Creek, CA 92358-9758

Mailing AddressPo Box 158Lytle Creek, CA 92358-0158 · (909) 900-6011

Phone(909) 900-6011

Organization SubpartNo

Authorized OfficialJohn DeatheragePastor · (909) 900-6011

Enumeration DateDecember 15, 2025

NPPES CertifiedDecember 14, 2025

✔ NPI 1285598243 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCase Manager/Care CoordinatorOther Service Providers

Taxonomy Code171M00000X

Definition

A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee's progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management.

585 LYTLE CREEK RD, Lytle Creek, CA 92358

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bloomington Pentecostal Church Of God's NPI number?

The NPI number for Bloomington Pentecostal Church Of God is 1285598243. It was assigned to this organization in the NPPES registry on December 15, 2025.

Where is Bloomington Pentecostal Church Of God located?

Bloomington Pentecostal Church Of God is located at 585 Lytle Creek Rd, Lytle Creek, CA 92358. The listed phone number is (909) 900-6011.

What is Bloomington Pentecostal Church Of God's specialty?

The primary specialty registered for this NPI is Case Manager/Care Coordinator with taxonomy code 171M00000X.

When was this NPI record last updated?

The NPPES record for Bloomington Pentecostal Church Of God was last updated on December 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.