GREEN LIFE LEGACY, LLC (NPI# 1639597677) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639597677 |
| Entity Type | Organization |
| Organization Name | GREEN LIFE LEGACY, LLC |
| Practice Address |
633 E Baseline Rd Claremont CA 91711-2270 |
| Practice Telephone | 9515700749 |
| Mailing Telephone | 9515700749 |
| Enumeration Date | 2014-04-06 |
| Last Update Date | 2014-04-06 |
| Authorized Official Name | EVELYN M MUGAR (ADMINISTRATOR) |
| Authorized Official Telephone | 9515700749 |
| 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 |
633 E BASELINE RD |
| City | CLAREMONT |
| State | CA |
| Zip Code | 91711-2270 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659919132 | Suzanne Kathryn Wen | Physical Therapist | 224 North Indian Hill Bvld, Claremont, CA 91711 | 2019-12-16 |
| 1336790690 | Angelita M Sherzada | Social Worker | 250 W. First Street, 242, Claremont, CA 91711 | 2019-09-26 |
| 1629560602 | Patricia L Sellers | Marriage & Family Therapist | 220 S Indian Hill Boulevard, Suite E, Claremont, CA 91711 | 2018-06-05 |
| 1477078418 | Geiselia Thomas | Chore Provider | 519 Martin Way, Claremont, CA 91711 | 2017-08-10 |
| 1750804464 | Vasudavan Govindasamy | Speech-Language Pathologist | 1490 North Claremont Blvd Suite 101, Claremont, CA 91711 | 2017-07-25 |
| 1669850103 | Drpaulolivera | Dentist | 450wsanjose, Claremont, CA 91711 | 2015-05-18 |
| 1003204504 | Alexandra Jordan Bandy | Nurse Practitioner | 530 W. Bonita Ave, Claremont, CA 91711 | 2015-01-06 |
| 1437571379 | Susan Clayton Zylstra | Speech-Language Pathologist | 842 Knox Place, Claremont, CA 91711 | 2014-01-13 |
| 1255671053 | Misty Anne Rogers | Acupuncturist | 689 W. Foothill Blvd., Suite D, Claremont, CA 91711 | 2013-02-15 |
| 1629364161 | Lu Tian | Acupuncturist | 250 W. First Street #112, Claremont, CA 91711 | 2011-06-23 |
| Find all providers in zip 91711 | ||||
| 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 |
|---|---|---|---|---|
| 1215143060 | Hemma, Inc | Intermediate Care Facility, Mentally Retarded | 1922 N Mountain Ave, Claremont, CA 91711-2605 | 2007-05-15 |
| 1962530220 | Normal Life of California, Inc. | Intermediate Care Facility, Mentally Retarded | 1040 Occidental Drive, Claremont, CA 91711 | 2007-03-01 |
| 1386772796 | Monte Vista Child Care Center Inc | Intermediate Care Facility, Mentally Retarded | 2472 Forbes Ave, Claremont, CA 91711-1717 | 2007-02-28 |
| 1215064589 | Rockcreek, Inc. | Intermediate Care Facility, Mentally Retarded | 305 Armstrong Dr, Claremont, CA 91711-1745 | 2007-02-27 |
| 1184751497 | Normal Life of California, Inc. | Intermediate Care Facility, Mentally Retarded | 581 Blaisdell Dr, Claremont, CA 91711-3555 | 2007-02-27 |
| 1124155494 | Rockcreek, Inc. | Intermediate Care Facility, Mentally Retarded | 4143 Las Casas Ave, Claremont, CA 91711-2302 | 2007-02-27 |
| 1588790380 | Rockcreek, Inc. | Intermediate Care Facility, Mentally Retarded | 501 Bowling Green Dr, Claremont, CA 91711-2717 | 2007-02-26 |
| 1871628966 | Rha Health Services Nc, LLC | Intermediate Care Facility, Mentally Retarded | 2810 Highway 70 East, Claremont, NC 28610-8527 | 2007-02-22 |
| 1003951542 | Rha Health Services Nc, LLC | Intermediate Care Facility, Mentally Retarded | 2840 E Us Highway 70, Claremont, NC 28610-8527 | 2007-02-21 |
| 1558472019 | Robilyn Guest Home, Inc. | Intermediate Care Facility, Mentally Retarded | 555 W San Jose Ave, Claremont, CA 91711 | 2006-08-31 |
| Find all providers in CLAREMONT | ||||
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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.