NPIMap

Organization Active NPI

Enter Care Maclay SWC

  • Skilled Nursing Facility
  • Sylmar, CA
National Provider Identifier
1073503074
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
ENTER CARE MACLAY SWC
Practice address
12831 Maclay St
Sylmar, CA 91342-4934
Phone
(818) 361-4455
Fax
(818) 837-9369
NPI assigned
Oct 21, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Mark John Donohoe
Title
Administrator
Phone
(818) 361-4455

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X CA Primary

Addresses

Primary practice location

12831 Maclay St
Sylmar, CA 91342-4934

Mailing address

12831 Maclay St
Sylmar, CA 91342-4934
Phone (818) 361-4455

Other identifiers 1

IdentifierTypeStateIssuer
LTC55583GMedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
Cypress Acres Convalescent Hospital6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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": "1129852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073503074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12831 MACLAY ST",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "913424934",
            "telephone_number": "818-361-4455",
            "fax_number": "818-837-9369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12831 MACLAY ST",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "913424934",
            "telephone_number": "818-361-4455",
            "fax_number": "818-837-9369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENTER CARE MACLAY SWC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DONOHOE",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "818-361-4455",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC55583G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sylmar, CA

Sources for this page

  • 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.