Madera Convalscent Hospital, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

MADERA CONVALSCENT HOSPITAL, INC.

Doing business as

Auburn Gardens Care Center

Practice address

260 Racetrack St
Auburn, CA 95603-5422

Phone

(530) 885-7051

Fax

(530) 885-7521

NPI assigned

Aug 31, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Arden Bennett

Title

Ceo

Phone

(559) 673-5149

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Auburn Gardens Care Center Doing business as

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104938976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "632 E YOSEMITE AVE",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936383343",
            "telephone_number": "559-673-5149",
            "fax_number": "559-673-7249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 RACETRACK ST",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956035422",
            "telephone_number": "530-885-7051",
            "fax_number": "530-885-7521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADERA CONVALSCENT HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "ARDEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "559-673-5149",
        "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": "ZZR05446H",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Auburn Gardens Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dennis Joe Lyons, BSW/RAS
• Paige Lee Maberry, PA-C
• Barbara Anne Macdonald, RN,PHN
• Macy Transportation & Communications Inc
• Victor Macy
• Diana Madrigal
• Lahela Maea
• David John Eric Magana, CADC-I
• Veronica Evette Magana
• Craig Maher

• Skilled Nursing Facility in Auburn, CA
• Providers in Auburn, 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.