FRED JEFFERSON MEMORIAL HOME #1
NPI 1679016554
Residential Treatment Facility, Emotionally Disturbed Children in Compton, CA

Q: What is Fred Jefferson Memorial Home For Boys's specialty?

The primary specialty registered for this NPI is Residential Treatment Facility, Emotionally Disturbed Children with taxonomy code 322D00000X.

Active since November 28, 2016

1000 W 152ND ST, COMPTON, CA 90220(310) 763-1660(310) 763-0357 Get Directions Write a Review

NPPES record last updated: March 3, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Mar 3, 2020, Jan 27, 2017 (2 updates tracked since 2017).

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About Fred Jefferson Memorial Home #1 NPPES

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

FRED JEFFERSON MEMORIAL HOME #1 (NPI 1679016554) is a healthcare organization registered as a residential treatment facility, emotionally disturbed children in Compton, California and active in the NPI registry since November 2016. The organization lists Niquelle Deondrea Lewis, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1679016554

Entity TypeOrganization

Primary Taxonomy322D00000X

Legal Business NameFRED JEFFERSON MEMORIAL HOME FOR BOYS

Location Address1000 W 152ND STCompton, CA 90220-2821

Mailing Address152 W Walnut St, Suite 150Gardena, CA 90248-3141 · (310) 763-1660 · Fax (310) 763-0357

Phone(310) 763-1660

Fax(310) 763-0357

Organization SubpartNo

Authorized OfficialNiquelle Deondrea LewisExecutive Director · (310) 763-1660

Enumeration DateNovember 28, 2016

Last NPPES UpdateMarch 3, 20202 updates tracked since enumeration

NPPES CertifiedMarch 3, 2020

✔ NPI 1679016554 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyResidential Treatment Facility, Emotionally Disturbed ChildrenResidential Treatment Facilities

Taxonomy Code322D00000X

Definition

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.

1000 W 152ND ST, Compton, CA 90220

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Other Names 1

Other NameFred Jefferson Memorial Home #1

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 Fred Jefferson Memorial Home For Boys's NPI number?

The NPI number for Fred Jefferson Memorial Home For Boys is 1679016554. It was assigned to this organization in the NPPES registry on November 28, 2016. The provider is also known as Fred Jefferson Memorial Home #1.

Where is Fred Jefferson Memorial Home For Boys located?

Fred Jefferson Memorial Home For Boys is located at 1000 W 152nd St, Compton, CA 90220. The listed phone number is (310) 763-1660.

What is Fred Jefferson Memorial Home For Boys's specialty?

The primary specialty registered for this NPI is Residential Treatment Facility, Emotionally Disturbed Children with taxonomy code 322D00000X.

When was this NPI record last updated?

The NPPES record for Fred Jefferson Memorial Home For Boys was last updated on March 3, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.