CRYSTAL CARE VILLA (NPI# 1598174484) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598174484 |
| Entity Type | Organization |
| Organization Name | CRYSTAL CARE VILLA |
| Practice Address |
6410 El Reposo Street Joshua Tree CA 92252-2352 |
| Practice Telephone | 7603663845 |
| Enumeration Date | 2014-08-05 |
| Last Update Date | 2014-08-05 |
| Authorized Official Name | SHIRLEY MAGNO (LICENSEE / OWNER) |
| Authorized Official Telephone | 6262556659 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| Street Address |
6410 EL REPOSO STREET |
| City | JOSHUA TREE |
| State | CA |
| Zip Code | 92252-2352 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609405992 | Micheline Helou | Nurse Practitioner | 63532 Twentynine Palms Highway, Joshua Tree, CA 92252 | 2020-04-07 |
| 1821558164 | Lisa Brown | Nurse Practitioner | 63532 29 Palms Hwy., Suite C, Joshua Tree, CA 92252 | 2019-03-22 |
| 1861990053 | Candice Amber Packard | Marriage & Family Therapist | 60805 29 Palms Hwy, Joshua Tree, CA 92252 | 2018-01-23 |
| 1194195529 | Jacob Edward Sanchez | Counselor | 60805 Twentynine Palms Hwy., Joshua Tree, CA 92252 | 2015-09-28 |
| 1023404357 | American Health Services LLC | Substance Abuse Rehabilitation Facility | 65675 Sullivan Rd., Joshua Tree, CA 92252 | 2015-04-14 |
| 1699940486 | Lee, Wee &baek. Dds. Inc | Clinic/Center | 61325 29palms Hwy.ste.a, Joshua Tree, CA 92252 | 2008-04-23 |
| 1447420690 | County of San Bernardino | Public Health or Welfare | 63532 29 Palms Highway, Suite D, Joshua Tree, CA 92252 | 2008-03-04 |
| 1861671679 | Lisa L Surace | Marriage & Family Therapist | 63532 Twentynine Palms Hwy, Suite C, Joshua Tree, CA 92252 | 2007-10-29 |
| 1821285271 | Morongo Basin Mental Health Services Ass., Inc | Substance Abuse Rehabilitation Facility | 65675 Sullivan Rd, Joshua Tree, CA 92252 | 2007-10-01 |
| 1295872067 | Angel View Crippled Childrens Foundation Inc | Intermediate Care Facility, Mentally Retarded | 60950 Sunburst, Joshua Tree, CA 92252 | 2007-01-31 |
| Find all providers in zip 92252 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043516776 | Holistic Assisted Living Inc | Assisted Living Facility | 6410 El Reposo St, Joshua Tree, CA 92252-2340 | 2011-01-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710588165 | Nana's Garden II | Assisted Living Facility | 25312 Ericson Way, Laguna Hills, CA 92653-5054 | 2020-11-03 |
| 1609476589 | Southbay Care Home, Inc. | Assisted Living Facility | 19917 Anza Avenue, Torrance, CA 90503-2005 | 2020-10-29 |
| 1821697434 | Global Regency Senior Care Services, LLC | Assisted Living Facility | 117 E 8th St, Long Beach, CA 90813-4397 | 2020-10-23 |
| 1689273419 | Pacifica Slo LLC | Assisted Living Facility | 475 Marsh St, San Luis Obispo, CA 93401-6108 | 2020-10-22 |
| 1871192682 | Pacifica Sfo LLC | Assisted Living Facility | 624 Laguna St, San Francisco, CA 94102-4217 | 2020-10-22 |
| 1528667367 | Pacifica Sierra Vista Lp | Assisted Living Facility | 13815 Rodeo Dr, Victorville, CA 92395-5600 | 2020-10-22 |
| 1992304737 | West Lyons Lp | Assisted Living Facility | 24305 Lyons Ave, Newhall, CA 91321-2344 | 2020-10-22 |
| 1619576451 | Pacifica Orange County LLC | Assisted Living Facility | 2619 Orange Ave, Costa Mesa, CA 92627-4630 | 2020-10-22 |
| 1720687551 | P San Leandro Lp | Assisted Living Facility | 348 W Juana Ave, San Leandro, CA 94577-3661 | 2020-10-22 |
| 1952900730 | Pacifica Daly LLC | Assisted Living Facility | 995 E Market St, Daly City, CA 94014-2168 | 2020-10-22 |
| Find all providers with the same taxonomy | ||||
| City | JOSHUA TREE |
| Zip Code | 92252 |
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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.