CRESTWOOD BEHAVIORAL HEALTH INC (NPI# 1902828403) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902828403 |
| Entity Type | Organization |
| Organization Name | CRESTWOOD BEHAVIORAL HEALTH INC |
| Other Organization Name | CRESTWOOD MANOR-FREMONT |
| Practice Address |
4303 Stevenson Blvd Fremont CA 94538-2645 |
| Mailing Address |
7590 Shoreline Dr Stockton CA 95219-5455 |
| Practice Telephone | 5106511244 |
| Practice Fax Number | 5106511127 |
| Mailing Telephone | 2099552328 |
| Mailing Fax Number | 2099525314 |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2015-05-19 |
| Authorized Official Name | LORI BLACKBURN (VICE PRESIDENT) |
| Authorized Official Telephone | 2099552322 |
| Is Organization Subpart | Y |
| Parent Organization Name | CRESTWOOD BEHAVIORAL HEALTH INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | LTC90080F | 05 |
| Other Name | Type Code |
|---|---|
| CRESTWOOD MANOR-FREMONT | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992206734 | Crestwood Behavioral Health Inc | Community Based Residential Treatment Facility, Mental Illness | 5550 University Ave Ste B, San Diego, CA 92105-2307 | 2018-02-27 |
| 1447758024 | Crestwood Behavioral Health Inc | Intermediate Care Facility, Mental Illness | 450 Stanyan St Fl 5, San Francisco, CA 94117-1019 | 2018-01-29 |
| 1992053631 | Crestwood Behavioral Health Inc | Skilled Nursing Facility | 482 Aztec Ln, Lathrop, CA 95330-9142 | 2012-08-28 |
| Street Address |
4303 STEVENSON BLVD |
| City | FREMONT |
| State | CA |
| Zip Code | 94538-2645 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699394460 | Bay Area Kidney Care Medical Group Inc. | Clinic/Center | 39370 Mozart Terrace Unit 106, Fremont, CA 94538 | 2020-04-13 |
| 1740847284 | Gloria Ann Federico | Behavior Technician | 39210 State St., Suite 220 Fremont, Ca 94538, Fremont, CA 94538 | 2019-05-21 |
| 1093270688 | Timothy Lorne Haynes | Chiropractor | 3775 Beacon Ave., Suite 200, Fremont, CA 94538 | 2019-02-07 |
| 1902370067 | Nicole Sandoval | Counselor | 39155 Liberty St Suite E500, Fremont, CA 94538 | 2019-01-11 |
| 1497225015 | Megan Galban | Behavior Technician | 39210 State St. Suite 220, Fremont, CA 94538 | 2018-11-27 |
| 1780154302 | Karla Patricia Plascencia | Behavior Technician | 39210 State Street Suite 220, Fremont, CA 94538 | 2018-11-27 |
| 1215407846 | Sydney J Torrens | Behavior Technician | 39210 State St. Suite 220 Fremont, Ca 94538, Fremont, CA 94538 | 2018-11-27 |
| 1932676277 | Jarah Harvan | Psychologist | 1999 Mowry Ave Ste F, Fremont, CA 94538 | 2018-10-24 |
| 1205321965 | Chien Shien Yang Md Inc | Psychiatry & Neurology | 1860 Mowry Ave Ste 301a, Fremont, CA 94538 | 2018-06-26 |
| 1912416199 | Advanced Interventional Surgical Center | Clinic/Center | 3077 Stevenson Blvd, Fremont, CA 94538 | 2017-09-20 |
| Find all providers in zip 94538 | ||||
| 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 |
|---|---|---|---|---|
| 1700037926 | Fremont Care Center Inc | Skilled Nursing Facility | 3210 North Clarkson, Fremont, NE 68025 | 2008-10-07 |
| 1487775052 | Ssc Fremont Operating Company LLC | Skilled Nursing Facility | 2550 N Nye Ave, Fremont, NE 68025-2242 | 2007-04-02 |
| 1285781013 | Windsor Convalescent and Rehabilitation Center of Fremont, LLC | Skilled Nursing Facility | 2400 Parkside Dr, Fremont, CA 94536-5332 | 2007-01-04 |
| 1255418364 | Trilogy Healthcare of Sandusky, LLC | Skilled Nursing Facility | 1247 N River Rd, Fremont, OH 43420 | 2006-11-01 |
| 1346333275 | Sky Blue Health Inc Dba Hillside Care Center | Skilled Nursing Facility | 38650 Mission Blvd, Fremont, CA 94536-4391 | 2006-10-02 |
| 1093813016 | Elmwood of Fremont, Ltd. | Skilled Nursing Facility | 1545 Fangboner Rd, Fremont, OH 43420-1128 | 2006-09-21 |
| 1295756526 | Volunteers of America Care Facilities | Skilled Nursing Facility | 600 N Brush St, Fremont, OH 43420-1402 | 2006-07-21 |
| 1124047386 | Helios Healthcare, LLC | Skilled Nursing Facility | 2500 Country Dr, Fremont, CA 94536-5356 | 2006-07-19 |
| 1942228838 | Crestwood Behavioral Health, Inc. | Skilled Nursing Facility | 2171 Mowry Ave, Fremont, CA 94538-1717 | 2006-07-18 |
| 1912949207 | Op 1 Fremont, Inc. | Skilled Nursing Facility | 1406 Oak Harbor Rd, Fremont, OH 43420-1025 | 2006-06-12 |
| Find all providers in FREMONT | ||||
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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.