Madison Care Center, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

MADISON CARE CENTER, LLC

Doing business as

Madison Care Center

Practice address

1391 E Madison Ave
El Cajon, CA 92021-8568

Phone

(619) 444-1107

Fax

(619) 444-1403

NPI assigned

Nov 10, 2005

Organization subpart

No

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

Authorized official

Name

Miss Dianne Faye Thibodeau

Title

Administrator

Phone

(619) 444-1107

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Madison Care Center Doing business as

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1033190400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1391 E MADISON AVE",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920218568",
            "telephone_number": "619-444-1107",
            "fax_number": "619-444-1403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1391 E MADISON AVE",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920218568",
            "telephone_number": "619-444-1107",
            "fax_number": "619-444-1403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISON CARE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "THIBODEAU",
        "authorized_official_first_name": "DIANNE",
        "authorized_official_middle_name": "FAYE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "619-444-1107",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT05064H",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Madison Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in El Cajon, CA
• Providers in El Cajon, 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 Aug 22, 2020; 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.