PREMIERCARE I CONGREGATE LIVING, INC. (NPI# 1063884641) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063884641 |
| Entity Type | Organization |
| Organization Name | PREMIERCARE I CONGREGATE LIVING, INC. |
| Practice Address |
2032 Cypress Ave Santa Ana CA 92707-2848 |
| Practice Telephone | 7148841281 |
| Practice Fax Number | 7148844282 |
| Mailing Telephone | 7148841281 |
| Mailing Fax Number | 7148844282 |
| Enumeration Date | 2015-10-22 |
| Last Update Date | 2015-10-22 |
| Authorized Official Name | MRS. MARILYN V NGUYEN (PRES/ADMINISTRATOR/DPCS) |
| Authorized Official Telephone | 7148841281 |
| Authorized Official Credential | RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 313M00000X | Nursing Facility/Intermediate Care Facility | Nursing & Custodial Care Facilities |
| Street Address |
2032 CYPRESS AVE |
| City | SANTA ANA |
| State | CA |
| Zip Code | 92707-2848 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831743301 | Nestor Carcache | Marriage & Family Therapist | 2201 Kilson Ave, Santa Ana, CA 92707 | 2019-08-01 |
| 1184113292 | Ma Nehemiah Valencia Galindo | Nurse Practitioner | 201 E. Sandpointe Ave, Suite 600, Santa Ana, CA 92707 | 2018-05-03 |
| 1780089565 | Raymond Nambar | Registered Nurse | 1030 W. Warner Ave., Santa Ana, CA 92707 | 2014-10-23 |
| 1366733073 | Yellowstone Women's First Step House, Inc. | Substance Abuse Rehabilitation Facility | 1621 Indus Street, Santa Ana Heights, CA 92707 | 2011-04-28 |
| 1972809051 | American Logistics Company, LLC | Transportation Broker | 530 W Dyer Rd, Santa Ana, CA 92707 | 2011-02-07 |
| 1972807022 | Faraz Valaie | Pediatrics | 15 Macarthur Place, #601, Santa Ana, CA 92707 | 2011-01-04 |
| 1073815353 | Alicia Tokunaga | Physician Assistant | 2621 S Bristol St #203, Santa Ana, CA 92707 | 2010-11-18 |
| 1518279017 | Laura Reynoso | Case Manager/Care Coordinator | 2416 S Main St., Santa Ana, CA 92707 | 2010-07-13 |
| 1477705671 | Vanessa E. Carmona | Counselor | 2416 S. Main St, Suite B, Santa Ana, CA 92707 | 2008-10-21 |
| 1144379785 | Community Dental Services | Dentist | 2 Macarthur Place, Santa Ana, CA 92707 | 2007-01-10 |
| Find all providers in zip 92707 | ||||
| Taxonomy Code | 313M00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Nursing Facility/Intermediate Care Facility |
| An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. |
| Notes: Source: Paraphrased from Section 1919 (a) of the Social Security Act. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922542653 | Santa Ana Congregate Living, LLC | Nursing Facility/Intermediate Care Facility | 1809 Nancy Ln, Santa Ana, CA 92706-2112 | 2016-12-15 |
| 1598156069 | Vericia Stevenson | Nursing Facility/Intermediate Care Facility | 2101 E 1st St, Santa Ana, CA 92705-4007 | 2015-02-05 |
| 1962500025 | Health Care Agency/ Ets | Nursing Facility/Intermediate Care Facility | 1030 W Warner Ave, Santa Ana, CA 92707 | 2006-09-20 |
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| 1265070064 | Janet's Enterprise, Inc | Nursing Facility/Intermediate Care Facility | 904 W 9th St Ste B1, Upland, CA 91786-4576 | 2019-12-12 |
| 1427692128 | Cg Estepa Care Home 2, Inc. | Nursing Facility/Intermediate Care Facility | 12800 Thornberg Way, Rancho Cordova, CA 95742-7812 | 2019-11-05 |
| 1669022547 | Continuum Living, LLC | Nursing Facility/Intermediate Care Facility | 24343 Pawnee Trl, Moreno Valley, CA 92557-5033 | 2019-09-12 |
| 1194296566 | Magnifique Congregate Living Inc | Nursing Facility/Intermediate Care Facility | 1827 W Avenue K12, Lancaster, CA 93534-6235 | 2018-12-11 |
| 1063994408 | Sinai Congregate Living Facility | Nursing Facility/Intermediate Care Facility | 1759 Windermere Drive, Lancaster, CA 93534-5319 | 2018-09-01 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.