NPIMap

Organization Active NPI

Interface Rehab, Inc.

  • Assisted Living Facility
  • Healdsburg, CA
National Provider Identifier
1053178244
Registry record updated Mar 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
INTERFACE REHAB, INC.
Practice address
1801 Boxheart Dr
Healdsburg, CA 95448-3269
Phone
(707) 756-5039
NPI assigned
Mar 4, 2024
Organization subpart
Yes
Parent organization
INTERFACE REHAB, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 7, 2024

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

Authorized official

Name
Mr. Ashwin Shah
Title
Mis Manager
Phone
(714) 646-8308

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

1801 Boxheart Dr
Healdsburg, CA 95448-3269

Mailing address

774 S Placentia Ave Ste 200
Placentia, CA 92870-6838
Phone (714) 646-8300

Other names 1

  • interface rehab, inc. at Enso Village Other name

National Provider Directory

National Provider Directory
Tax ID family
Interface Rehab Inc2 organizations share this tax ID, including this one
Part of
Interface Rehab Inc

Other organizations with this tax ID 1

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 57

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

View all 57

NPI Registry JSON

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

{
    "created_epoch": "1709510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709769600000",
    "number": "1053178244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "774 S PLACENTIA AVE STE 200",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "928706838",
            "telephone_number": "714-646-8300",
            "fax_number": "714-646-8183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 BOXHEART DR",
            "city": "HEALDSBURG",
            "state": "CA",
            "postal_code": "954483269",
            "telephone_number": "707-756-5039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERFACE REHAB, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INTERFACE REHAB, INC.",
        "enumeration_date": "2024-03-04",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "ASHWIN",
        "authorized_official_title_or_position": "MIS MANAGER",
        "authorized_official_telephone_number": "714-646-8308",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "interface rehab, inc. at Enso Village",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "interface rehab, inc. at Enso Village",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Healdsburg, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2024; 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.