IMPERIAL CREST HEALTHCARE CENTER, LLC (NPI# 1316033087) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316033087 |
| Entity Type | Organization |
| Organization Name | IMPERIAL CREST HEALTHCARE CENTER, LLC |
| Other Organization Name | IMPERIAL CREST HEALTH CARE CENTER |
| Practice Address |
11834 Inglewood Ave Hawthorne CA 90250-0107 |
| Mailing Address |
4032 Wilshire Blvd Fl 6 Los Angeles CA 90010-3425 |
| Practice Telephone | 3106791461 |
| Practice Fax Number | 3106792511 |
| Mailing Telephone | 2133896900 |
| Mailing Fax Number | 2133688560 |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2016-06-22 |
| Authorized Official Name | MR. DAVID FRIEDMAN (MANAGING MEMBER) |
| Authorized Official Telephone | 2133896900 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 910000054 | CA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | LTC55719F | 05 |
| Other Name | Type Code |
|---|---|
| Imperial Crest Health Care Center | Doing Business As Name - Organization |
| Street Address |
11834 INGLEWOOD AVE |
| City | HAWTHORNE |
| State | CA |
| Zip Code | 90250-0107 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508479627 | Alexis Lemmon | Dental Hygienist | 13450 Hawthrone Blvd, Hawthorne, CA 90250 | 2020-08-28 |
| 1336620459 | Lan Ngoc Ton | Dentist | 13450 S. Hawthorne Blvd, Hawthorne, CA 90250 | 2018-08-27 |
| 1356829261 | Karneth Health Inc | Internal Medicine | 4512 W. Imperial Hwy, Ste B, Hawthorne, CA 90250 | 2018-08-02 |
| 1225524663 | Viridian Healthcare LLC | In Home Supportive Care | 13658 Hawthorne Blvd Ste 201, Hawthorne, CA 90250 | 2018-07-09 |
| 1235636044 | Sonia Medical Center Inc | Clinic/Center | 4512 W Imperial Hwy, Hawthorne, CA 90250 | 2018-04-09 |
| 1518484807 | Jessica Anne-marie Auzenne-harris | Nurse Practitioner | 12618 Hawthorne Blvd, Hawthorne, CA 90250 | 2017-08-28 |
| 1669993358 | Ololade Olamide Obafemi | Nurse Practitioner | 12954 Hawthorne Boulevard, Suite 104, Hawthorne Morningside Medical Clinic, Hawthorne, CA 90250 | 2017-07-03 |
| 1588194534 | Marissam Medical Inc. | Durable Medical Equipment & Medical Supplies | 13508 Inglewood Ave, Hawthorne, CA 90250 | 2017-06-13 |
| 1043751886 | Ogbonna Iwuamadi Olelewe | Nurse Practitioner | 11712 S. Hawthorne Blvd, Hawthorne, CA 90250 | 2017-03-13 |
| 1952758898 | La Shada Kai Martin | Contractor | 13010 Kornblum Ave, Unit D, Hawthorne, CA 90250 | 2016-05-20 |
| Find all providers in zip 90250 | ||||
| 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 |
|---|---|---|---|---|
| 1720444904 | Rhea Riza Talaver | Skilled Nursing Facility | 3854 W 144th St, Hawthorne, CA 90250-8364 | 2016-01-04 |
| 1831476365 | Hawthorne Healthcare & Wellness Centre, Lp | Skilled Nursing Facility | 11630 Grevillea Ave, Hawthorne, CA 90250-2231 | 2011-11-11 |
| 1891815262 | Rosary Hill Home | Skilled Nursing Facility | 600 Linda Ave, Hawthorne, NY 10532-1362 | 2007-03-30 |
| 1487735072 | Westchester County Health Care Corporation | Skilled Nursing Facility | 25 Bradhurst Ave, Tcc Administration, Hawthorne, NY 10532-2115 | 2006-10-18 |
| 1114915121 | Sandhurst Convalescent Group, Ltd. | Skilled Nursing Facility | 13922 Cerise Ave, Hawthorne, CA 90250-8688 | 2005-10-12 |
| 1164410759 | Hardi Health Care, Inc | Skilled Nursing Facility | 11630 S. Grevillea Ave, Hawthorne, CA 90250-2231 | 2005-10-09 |
| 1801406772 | Pine Forest Healthcare, Inc. | Skilled Nursing Facility | 13922 Cerise Ave, Hawthorne, CA 90250-8118 | 2020-08-05 |
| 1518157155 | Isocare Convalescent Hospital of Monte Vista Inc. | Skilled Nursing Facility | 13527 Hawthorne Blvd, Hawthorne, CA 90250-5807 | 2007-07-30 |
| 1073561718 | Mt Grant General Hospital | Skilled Nursing Facility | 200 South A Street, Hawthorne, NV 89415-1510 | 2006-05-05 |
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|---|---|---|---|---|
| 1073114807 | The Healing Sanctum-greenmeadow, LLC | Skilled Nursing Facility | 5302 E Greenmeadow Rd, Long Beach, CA 90808-1620 | 2020-11-06 |
| 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.