Manor Care of Citrus Heights Ca LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

030000360 Issued in CA

Legal business name

MANOR CARE OF CITRUS HEIGHTS CA LLC

Doing business as

ProMedica Skilled Nursing and Rehabilitation (Citrus Heights)

Practice address

7807 Uplands Way
Citrus Heights, CA 95610-7500

Phone

(916) 967-2929

Fax

(916) 965-8439

NPI assigned

Jun 1, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Martin D Allen

Title

Director

Phone

(419) 252-5734

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• ProMedica Skilled Nursing and Rehabilitation (Citrus Heights) Doing business as

Electronic endpoints 1

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644537600000",
    "number": "1003853979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N SUMMIT ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436042615",
            "telephone_number": "419-252-5500",
            "fax_number": "877-385-9446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7807 UPLANDS WAY",
            "city": "CITRUS HEIGHTS",
            "state": "CA",
            "postal_code": "956107500",
            "telephone_number": "916-967-2929",
            "fax_number": "916-965-8439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANOR CARE OF CITRUS HEIGHTS CA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-01",
        "last_updated": "2022-02-11",
        "certification_date": "2022-02-11",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "419-252-5734",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "030000360",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003853979",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N St 6th #900a",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "55403",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "ProMedica Skilled Nursing and Rehabilitation (Citrus Heights)",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ProMedica Skilled Nursing and Rehabilitation (Citrus Heights)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Reyna Michelle Mangino
• Alicia Manisisaket
• Banjot Kaur Mann
• Christine Charlotte Mann
• Aubrey Rose Sumpo Manongsong, LMFT
• Lillian D. Manship, L.AC.
• Amanda Lynn Manson
• Maria Marcheschi, RN
• Zandra Yuvozka Mardones
• Andrew Christopher Markus

• Skilled Nursing Facility in Citrus Heights, CA
• Providers in Citrus Heights, CA by specialty
• Skilled Nursing Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2022; 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.