NPIMap

Organization Active NPI

PSB Homes Inc. Dracaena Homes

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Buena Park, CA
National Provider Identifier
1003245499
Registry record updated Nov 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
Legal business name
PSB HOMES INC. DRACAENA HOMES
Practice address
8241 Dracaena Dr
Buena Park, CA 90620-4014
Phone
(714) 826-6652
Fax
(714) 779-7268
NPI assigned
Nov 5, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Priscilla Bustamante
Title
Owner/Administrator
Phone
(714) 926-2352

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X CA Primary

Addresses

Primary practice location

8241 Dracaena Dr
Buena Park, CA 90620-4014

Mailing address

8241 Dracaena Dr
Buena Park, CA 90620-4014
Phone (714) 826-6652

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Intermediate care facility for individuals with intellectual disabilities certification: CCN 55G034

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
PSB HOMES, INC/DRACAENA HOME
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Dec 6, 1996
Last certification
Sep 23, 2025
Beds
6
Ownership / control type
Private (proprietary)
Most recent change of ownership
Dec 27, 2011
Facility address
8241 Dracaena Drive
Buena Park, CA 90620

National Provider Directory

National Provider Directory
Tax ID family
Casa de Yorba Linda2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1383609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383609600000",
    "number": "1003245499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8241 DRACAENA DR",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906204014",
            "telephone_number": "714-826-6652",
            "fax_number": "714-779-7268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8241 DRACAENA DR",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906204014",
            "telephone_number": "714-826-6652",
            "fax_number": "714-779-7268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSB HOMES INC. DRACAENA HOMES",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-05",
        "last_updated": "2013-11-05",
        "status": "A",
        "authorized_official_last_name": "BUSTAMANTE",
        "authorized_official_first_name": "PRISCILLA",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "714-926-2352"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buena Park, CA

Sources for this page

Verify at the official NPI Registry.