COUNTRY VILLA PARK MARINO HEALTHCARE CENTER, LLC


Address: 2585 E Washington Blvd, Pasadena, CA 91107-1446
Phone: 6264634105

COUNTRY VILLA PARK MARINO HEALTHCARE CENTER, LLC (NPI# 1811982176) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1811982176
Entity Type Organization
Organization Name COUNTRY VILLA PARK MARINO HEALTHCARE CENTER, LLC
Other Organization Name COUNTRY VILLA PARK MARINO HEALTHCARE CENTER
Practice Address 2585 E Washington Blvd
Pasadena
CA 91107-1446
Mailing Address 5120 W Goldleaf Cir
Suite 400
Los Angeles
CA 90056-1292
Practice Telephone 6264634105
Practice Fax Number 6267985121
Mailing Telephone 3105743733
Mailing Fax Number 3105741322
Enumeration Date 2005-09-13
Last Update Date 2009-01-20
Authorized Official Name MR. STEPHEN E. REISSMAN (PRESIDENT OF CVHS, MANAGER)
Authorized Official Telephone 3105743733
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 314000000X Skilled Nursing Facility 970000088 CA Nursing & Custodial Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
CA LTC05548F 05

Other Provider/Organization Names

Other Name Type Code
Country Villa Park Marino Healthcare Center Doing Business As Name - Organization

Office Location

Street Address 2585 E WASHINGTON BLVD
City PASADENA
State CA
Zip Code 91107-1446

Providers in the same location

NPI Name Taxonomy Address Enumeration
1528348828 San Marino Gardens Wellness Center, Lp Skilled Nursing Facility 2585 E Washington Blvd, Pasadena, CA 91107-1446 2011-08-18
1023262029 San Marino Skilled Nursing and Wellness Centre Skilled Nursing Facility 2585 E Washington Blvd, Pasadena, CA 91107 2008-11-05

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1801412002 Kwasi Nkansa Physical Medicine & Rehabilitation 2585 East Washington Blvd, Pasadena, CA 91107 2020-06-23
1609402742 H & S Hospice Care Inc Hospice Care, Community Based 2525 E Colordo Blvd Suite 109, Pasadena, CA 91107 2020-03-20
1013557115 Cindy Phun Pharmacist 3383 E Foothill Blvd, Pasadena, CA 91107 2020-01-07
1184185548 Preferred Home Health Services Home Health 40 N Atlandena Dr Suite 219, Pasadena, CA 91107 2019-03-28
1861973729 Julia E Underwood Doula 2335-115 E. Colorado Blvd #339, Pasadena, CA 91107 2018-08-28
1982183166 Melissa Castillo Counselor 26 S Kinneloa Ave, Pasadena, CA 91107 2018-08-09
1083109904 Lourice Boutros Optometrist 3235 E Colorado Blvd Ste 101, Pasadena, CA 91107 2018-06-22
1902313026 Cecily Brogdon Marriage & Family Therapist 2115 Lambert Drive, Pasadena, CA 91107 2018-01-10
1790204915 Vanessa Nicole Contreras Licensed Vocational Nurse 36 S. Kinneiloa Ave., Pasadena, CA 91107 2017-09-19
1730614397 Rita Mason Behavioral Analyst 890 S Rosemead Blvd, Ste 45, Pasadena, CA 91107 2017-04-20
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Taxonomy Information

Taxonomy Code 314000000X
Grouping Nursing & Custodial Care Facilities
Classification Skilled Nursing Facility

Taxonomy Definition

(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.

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1154968055 Pasadena Congregate Living, Inc. Skilled Nursing Facility 1165 N Summit Ave, Pasadena, CA 91103-2655 2019-12-10
1891142006 Rose Garden Subacute & Rehabilitation Center LLC Skilled Nursing Facility 1899 N Raymond Ave, Pasadena, CA 91103-1733 2016-05-17
1700136132 Apollo Healthcare At Bay Area, Lp Skilled Nursing Facility 4900 East Sam Houston Parkway South, Pasadena, TX 77505 2012-09-13
1578812079 Apollo Healthcare At Bay Area, Lp Skilled Nursing Facility 4900 E. Sam Houston South, Pasadena, TX 77502 2012-08-30
1295011302 Severna Park Center Skilled Nursing Facility 8671 Scorton Harbour, Pasadena, MD 21122-6513 2011-11-02
1801171186 Baywood Crenshaw LLC Skilled Nursing Facility 5020 Space Center Blvd, Pasadena, TX 77505-3966 2011-10-18
1912125683 Liberty County Hospital District No 1 Skilled Nursing Facility 4048 Red Bluff Road, Pasadena, TX 77503 2007-04-20
1104947647 Ssc Pasadena Operating Company LLC Skilled Nursing Facility 811 Garner Rd, Pasadena, TX 77502-2315 2007-04-03
1154480234 Slch Inc Skilled Nursing Facility 1570 N Fair Oaks Ave, Pasadena, CA 91103 2006-12-06
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Competitor

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City PASADENA
Zip Code 91107

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Dataset Information

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.

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