Quincy Manor LLC

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

Legal business name

QUINCY MANOR LLC

Practice address

115 N Chester Ave
Compton, CA 90221-2701

Phone

(313) 106-3599

NPI assigned

Apr 7, 2025

Organization subpart

No

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

Authorized official

Name

Mr. Xavier Costolino Hogan Sr.NPI 1235923343

Title

Owner

Phone

(562) 450-7211

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Xavier Costolino Hogan Sr.

  • Nursing Home Administrator
  • Compton, CA
  • NPI 1235923343
  NPD Authorized official

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

{
    "created_epoch": "1743984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743984000000",
    "number": "1003600800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 N CHESTER AVE",
            "city": "COMPTON",
            "state": "CA",
            "postal_code": "902212701",
            "telephone_number": "313-106-3599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 N CHESTER AVE",
            "city": "COMPTON",
            "state": "CA",
            "postal_code": "902212701",
            "telephone_number": "313-106-3599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUINCY MANOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-07",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A",
        "authorized_official_last_name": "HOGAN",
        "authorized_official_first_name": "XAVIER",
        "authorized_official_middle_name": "COSTOLINO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "562-450-7211",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deontray Pugh
• Neerja Puri, M.D.
• Quiclinics Medical Partners
• Anthony Jerome Quiette
• Ronald Jerome Quiette
• Olivia M Quinonez, COUNSELOR
• Yesenia E Quintanilla
• Qureshi Dental Corporation
• Azeem Harris Qureshi, D.D.S.
• Radimot, Inc.

• Nursing Facility/Intermediate Care Facility in Compton, CA
• Providers in Compton, CA by specialty
• Nursing Facility/Intermediate Care Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.