PARK REGENCY CARE LLC (NPI# 1184720005) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184720005 |
| Entity Type | Organization |
| Organization Name | PARK REGENCY CARE LLC |
| Other Organization Name | PARK REGENCY CARE CENTER |
| Practice Address |
1770 W La Habra Blvd La Habra CA 90631 |
| Mailing Address |
3050 Saturn Street Suite #201 Brea CA 92821-6278 |
| Practice Telephone | 7147730750 |
| Practice Fax Number | 5626978478 |
| Mailing Telephone | 7145773880 |
| Mailing Fax Number | 7145773895 |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. MARK A MORTENSEN (SR VP FINANCE) |
| Authorized Official Telephone | 7145773880 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | CA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | LTC55536G | 05 |
| Other Name | Type Code |
|---|---|
| Park Regency Care Center | Doing Business As Name - Organization |
| Street Address |
1770 W LA HABRA BLVD |
| City | LA HABRA |
| State | CA |
| Zip Code | 90631 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477923027 | Alexander Chavez | Clinic/Center | 1770 W La Habra Blvd, La Habra, CA 90631-5130 | 2015-09-25 |
| 1528456969 | Jc Frances Castillo Baloy | Occupational Therapist | 1770 W La Habra Blvd, La Habra, CA 90631-5130 | 2015-01-08 |
| 1679961015 | Paul Emerson Baloy | Occupational Therapist | 1770 W La Habra Blvd, La Habra, CA 90631-5130 | 2015-01-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174163323 | Knowledge of Autism & Other Developmental Disabilities, LLC. | Assistant Behavior Analyst | 890 Whitebook Drive, La Habra, CA 90631 | 2020-01-15 |
| 1215572417 | Anthony Alonzo Favot | Physician Assistant | 2500 Sidon Ave., La Habra, CA 90631 | 2019-11-12 |
| 1487123618 | Adrian Acosta Dds A Prof Dental Corp | Dentist | 901 W. Whittier Blvd, La Habra, CA 90631 | 2018-11-16 |
| 1669961587 | La Habra Villa, LLC | Assisted Living Facility | 1100 E.whittier Blvd, La Habra, CA 90631 | 2018-05-07 |
| 1679089767 | Alicia Igarta | Behavioral Analyst | 890 Whitebook Dr, La Habra, CA 90631 | 2017-12-27 |
| 1609386564 | Antoinette Marie Burgonio | Counselor | 820 Buena Vista Ave, La Habra, CA 90631 | 2017-10-05 |
| 1023527710 | Sharon Rose Stines | Counselor | 271 W. Imperial Hwy, Suite C, La Habra, CA 90631 | 2017-09-25 |
| 1275050999 | Ivan Andro Simunovic | Physician Assistant | 1341 Brookdale Ave., La Habra, CA 90631 | 2017-08-23 |
| 1730609645 | Lorraine Danielle Granado | Specialist/Technologist | 2301 Las Palomas Dr, La Habra Heights, CA 90631 | 2017-06-21 |
| 1649717844 | Marzieh Simonton | Nurse Practitioner | 921 Donnybrook Ave, La Habra, CA 90631 | 2017-01-25 |
| Find all providers in zip 90631 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659326718 | Life Care Centers of America, Inc. | Skilled Nursing Facility | 1233 W La Habra Blvd, La Habra, CA 90631-5226 | 2006-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
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| 1528667581 | Winterfest Medical Services Corporation | Skilled Nursing Facility | 8758 Winterfest Way, Elk Grove, CA 95624-1295 | 2020-10-21 |
| 1689272528 | Orchards Hc LLC | Skilled Nursing Facility | 1 Amistad Drive, Rancho Mission Viejo, CA 92694 | 2020-10-13 |
| 1083223481 | Santa Clarita Congregate Living Inc | Skilled Nursing Facility | 29830 Wisteria Valley Rd, Santa Clarita, CA 91387-1954 | 2020-07-31 |
| 1033737051 | Beautiful Homes Residential Care Inc | Skilled Nursing Facility | 22525 Cerise Ave, Torrance, CA 90505-2913 | 2020-07-07 |
| 1043837966 | Desert Ridge Transitional Care Center, Lp | Skilled Nursing Facility | 13300 11th Avenue, Victorville, CA 92395 | 2020-06-26 |
| 1881210847 | Ghc of Tem - Snf, LLC | Skilled Nursing Facility | 44320 Campanula Way, Temecula, CA 92592-7903 | 2020-06-24 |
| 1861018327 | Covina Clhf Corporation | Skilled Nursing Facility | 1411 S Sandia Ave, West Covina, CA 91790-3309 | 2020-06-22 |
| 1780204024 | Neighbor Care Congregate Home, Inc. | Skilled Nursing Facility | 3249 Gerald Dr, Newbury Park, CA 91320-2948 | 2020-04-16 |
| 1558998047 | Sunflower Clhf, Inc. | Skilled Nursing Facility | 1058 Ruberta Ave, Glendale, CA 91201-2105 | 2020-03-24 |
| 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.