NPIMap

Organization Active NPI

Valley Care Residential

  • Intellectual Disabilities Intermediate Care Facility
  • Fresno, CA
National Provider Identifier
1073649307
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
VALLEY CARE RESIDENTIAL
Practice address
186 E Portland Ave
Fresno, CA 93720-2081
Phone
(559) 432-5025
Fax
(559) 431-6985
NPI assigned
Feb 23, 2007
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
Andrea Rengstorf
Title
RN Treasurer
Phone
(559) 322-9305

Specialties & licenses 1

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

Addresses

Primary practice location

186 E Portland Ave
Fresno, CA 93720-2081

Mailing address

1903 E Fir Ave
101
Fresno, CA 93720-3842
Phone (559) 322-9305

Other identifiers 1

IdentifierTypeStateIssuer
LTC80096GOtherCALONG TERM CARE PROVIDER

Other names 1

  • Portland House Other name

National Provider Directory

National Provider Directory
Tax ID family
Cedar House6 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": "1172188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073649307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1903 E FIR AVE",
            "address_2": "101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203842",
            "telephone_number": "559-322-9305",
            "fax_number": "559-322-9882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "186 E PORTLAND AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937202081",
            "telephone_number": "559-432-5025",
            "fax_number": "559-431-6985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY CARE RESIDENTIAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RENGSTORF",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "RN TREASURER",
        "authorized_official_telephone_number": "559-322-9305"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LONG TERM CARE PROVIDER",
            "identifier": "LTC80096G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Portland House",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fresno, 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.