NPIMap

Organization Active NPI

Marcee Lynn Hirst

  • Intellectual Disabilities Intermediate Care Facility
  • Norco, CA
National Provider Identifier
1053452789
Registry record updated Jun 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
250000742 Issued in CA
Legal business name
MARCEE LYNN HIRST
Practice address
368 Greentree Rd
Norco, CA 92860-1722
Phone
(951) 789-9698
NPI assigned
Feb 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2008

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

Authorized official

Name
Greg Hirst
Title
Owner
Phone
(951) 789-9698

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 250000742 CA Primary

Addresses

Primary practice location

368 Greentree Rd
Norco, CA 92860-1722

Mailing address

PO Box 8175
Riverside, CA 92515-8175
Phone (951) 789-9698

Other identifiers 1

IdentifierTypeStateIssuer
LTC80274FMedicaidCA

Other names 1

  • Green Tree House Other name

National Provider Directory

National Provider Directory
Tax ID family
Bentley House3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214179200000",
    "number": "1053452789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8175",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925158175",
            "telephone_number": "951-789-9698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "368 GREENTREE RD",
            "city": "NORCO",
            "state": "CA",
            "postal_code": "928601722",
            "telephone_number": "951-789-9698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARCEE LYNN HIRST",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2008-06-23",
        "status": "A",
        "authorized_official_last_name": "HIRST",
        "authorized_official_first_name": "GREG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "951-789-9698"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "CA",
            "license": "250000742",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC80274F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Green Tree House",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Norco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; 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.