NORTHERN CALIFORNIA ADAPTIVE LIVING CENTER, INC. (NPI# 1609089630) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609089630 |
| Entity Type | Organization |
| Organization Name | NORTHERN CALIFORNIA ADAPTIVE LIVING CENTER, INC. |
| Other Organization Name | MOUNTAINVIEW FACILITY |
| Practice Address |
1000 Sanford Ranch Rd Ukiah CA 95482-5241 |
| Mailing Address |
3028 Esplanade Suite H Chico CA 95973-4924 |
| Practice Telephone | 7074689331 |
| Practice Fax Number | 7074689007 |
| Mailing Telephone | 5308942726 |
| Mailing Fax Number | 5308942798 |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | SUSAN C KOLAR (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 5308942726 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | CA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDI-CAL | LTC60313G | 01 |
| Other Name | Type Code |
|---|---|
| Mountainview Facility | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578779286 | Northern California Adaptive Living Center, Inc. | Intermediate Care Facility, Mentally Retarded | 1116 W Perkins St, Ukiah, CA 95482-4625 | 2007-05-16 |
| 1528273836 | Northern California Adaptive Living Center, Inc. | Nursing Facility/Intermediate Care Facility | 7501 Uva Dr, Redwood Valley, CA 95470-6213 | 2007-05-11 |
| 1255544276 | Northern California Adaptive Living Center, Inc. | Intermediate Care Facility, Mentally Retarded | 850 Road N, Redwood Valley, CA 95470-6433 | 2007-05-07 |
| 1043423155 | Northern California Adaptive Living Center, Inc. | Intermediate Care Facility, Mentally Retarded | 3028 Esplanade, Suite H, Chico, CA 95973-4924 | 2007-05-07 |
| Street Address |
1000 SANFORD RANCH RD |
| City | UKIAH |
| State | CA |
| Zip Code | 95482-5241 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932726726 | Gloria Gonzalez Campise | Midwife | 205 W. Clay Street, Ukiah, CA 95482 | 2020-06-29 |
| 1083255095 | Mendocino Care Network | Internal Medicine | 1080 N State St, Ukiah, CA 95482 | 2019-10-01 |
| 1801383153 | Costco Wholesale Corporation | Pharmacy | 1275 Airport Park Blvd., Ukiah, CA 95482 | 2018-04-21 |
| 1922528256 | Ian David Winter | Case Manager/Care Coordinator | 1120 S. Dora St, Ukiah, CA 95482 | 2017-06-27 |
| 1568917938 | Rebecca Ann Dragomani | Nurse Practitioner | 260 Hospital Dr Ste 101, Ukiah, CA 95482 | 2016-08-16 |
| 1811362536 | Manzanita Services, Inc. | Community/Behavioral Health | 410 W. Jones St., Ukiah, CA 95482 | 2015-12-07 |
| 1689061061 | Pamela Mathias | Counselor | 367 East Gobbi Street, Suite E, Ukiah, CA 95482 | 2015-04-23 |
| 1275927030 | Jack David Segel | Counselor | 564 Dora St., Ste.d, Ukiah, CA 95482 | 2015-03-19 |
| 1689070211 | Mendocino County Youth Project | Clinic/Center | 347 Plum St, #b, Ukiah, CA 95482 | 2014-11-10 |
| 1346649951 | Ae Ran Ku | Dentist | 1096 South Dora Street, Ukiah, CA 95482 | 2014-08-19 |
| Find all providers in zip 95482 | ||||
| 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 |
|---|---|---|---|---|
| 1578779286 | Northern California Adaptive Living Center, Inc. | Intermediate Care Facility, Mentally Retarded | 1116 W Perkins St, Ukiah, CA 95482-4625 | 2007-05-16 |
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| 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 |
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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.