ANTON'S HOME, INC. (NPI# 1164081089) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164081089 |
| Entity Type | Organization |
| Organization Name | ANTON'S HOME, INC. |
| Practice Address |
2598 Olympic Drive San Bruno CA 94066-1251 |
| Mailing Address |
4358 Callan Blvd. Daly City CA 94015-4404 |
| Practice Telephone | 6505535009 |
| Practice Fax Number | 8508783131 |
| Mailing Telephone | 4159873401 |
| Mailing Fax Number | 6508783131 |
| Enumeration Date | 2019-06-13 |
| Last Update Date | 2019-06-13 |
| Authorized Official Name | MRS. ESTELITA SANTIAGO EVANGELISTA (PRESIDENT) |
| Authorized Official Telephone | 4159873401 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | Nursing & Custodial Care Facilities |
| Street Address |
2598 OLYMPIC DRIVE, |
| City | SAN BRUNO |
| State | CA |
| Zip Code | 94066-1251 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497392468 | Harold Relosimon | Behavior Technician | 901 Sneath Lane, Suite 105, San Bruno, Ca 94066, San Bruno, CA 94066 | 2019-12-09 |
| 1093365926 | Liana Greene | Behavior Technician | 1001 Sneath Lane #200, San Bruno, CA 94066 | 2019-09-12 |
| 1568018406 | Susan Page Gadegone | Community Health Worker | 931 San Bruno West Avenue Suite 2, San Bruno, CA 94066 | 2019-08-15 |
| 1184198780 | Sonya Oey Kramer | Pharmacist | 10 Bayhill Drive, San Bruno, CA 94066 | 2019-01-16 |
| 1316410350 | Brennen Marques Mcdowell | Behavioral Analyst | 101 Sneath Lane Ste. 200, 200, San Bruno, CA 94066 | 2019-01-02 |
| 1306317649 | Jacqueline R Lalucis | Behavior Technician | 751 Camino Plaza, San Bruno, Ca 94066, A, San Bruno, CA 94066 | 2018-12-16 |
| 1992275952 | Kenny Malunay | Behavior Technician | 75a El Camino Plaza, San Bruno, CA 94066 | 2018-12-03 |
| 1396236584 | Mariela Pena Yerena | Behavior Technician | 751 El Camino Plaza, Suite A, San Bruno, CA 94066 | 2018-05-23 |
| 1568845816 | Paula Leeanne Park | Physical Therapist | 106 Quail Point Cir, San Bruno, CA 94066 | 2015-07-06 |
| 1275921231 | C & C's Care Home | Assisted Living Facility | 2700 Oakmont Dr., San Bruno, CA 94066 | 2014-12-29 |
| Find all providers in zip 94066 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962627885 | Lesters Home Inc. | Intermediate Care Facility, Mentally Retarded | 3271 Susan Dr, San Bruno, CA 94066-1639 | 2007-04-16 |
| 1013131671 | B & M Inc. - Fleetwood | Intermediate Care Facility, Mentally Retarded | 2796 Fleetwood Dr, San Bruno, CA 94066-2627 | 2007-04-12 |
| 1386784312 | C.r.e. Enterprise, Inc. | Intermediate Care Facility, Mentally Retarded | 2601 Cottonwood Dr, San Bruno, CA 94066-2619 | 2007-02-07 |
| 1073663274 | Berkshire Manor Inc | Intermediate Care Facility, Mentally Retarded | 2820 Berkshire Dr, San Bruno, CA 94066-1754 | 2007-01-11 |
| 1427108620 | Seacliff Icf Ddh Inc | Intermediate Care Facility, Mentally Retarded | 2040 Sea Cliff Way, San Bruno, CA 94066 | 2007-01-11 |
| 1255488664 | Staffing International Inc | Intermediate Care Facility, Mentally Retarded | 2598 Olympic Drive, San Bruno, CA 94066 | 2007-01-05 |
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| 1003441155 | Sunrise Premier Homes LLC | Intermediate Care Facility, Mentally Retarded | 13831 Ruther Ave, Paramount, CA 90723-2662 | 2020-03-10 |
| 1649805912 | Jingma Inc | Intermediate Care Facility, Mentally Retarded | 34909 Osprey Dr, Union City, CA 94587-4618 | 2020-03-07 |
| 1124661699 | Rscr California, Inc. | Intermediate Care Facility, Mentally Retarded | 581 S Gilmar St, Anaheim, CA 92802-1306 | 2019-10-28 |
| 1467095935 | Rscr California, Inc. | Intermediate Care Facility, Mentally Retarded | 1592 W Lorane Way, Anaheim, CA 92802-3930 | 2019-10-28 |
| 1992348460 | Rscr California, Inc. | Intermediate Care Facility, Mentally Retarded | 5940 Los Angeles Way, Buena Park, CA 90620-2723 | 2019-10-28 |
| 1578106043 | Rscr California, Inc. | Intermediate Care Facility, Mentally Retarded | 2918 E Greenhedge Ave, Anaheim, CA 92806-3804 | 2019-10-28 |
| 1790328680 | Rscr California, Inc. | Intermediate Care Facility, Mentally Retarded | 2143 W Fir Ave, Anaheim, CA 92801-3436 | 2019-10-23 |
| 1356984249 | Rscr California, Inc. | Intermediate Care Facility, Mentally Retarded | 6540 Christine Cir, Buena Park, CA 90620-4511 | 2019-10-23 |
| Find all providers with the same taxonomy | ||||
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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.