Children'S Recovery Center 1, LLC

Primary specialty

Children's HospitalTaxonomy code 282NC2000X

License

070000320 Issued in CA

Legal business name

CHILDREN'S RECOVERY CENTER 1, LLC

Practice address

3777 S. Bascom Ave.
Campbell, CA 95008

Phone

(408) 340-1568

Fax

(408) 866-8144

NPI assigned

Nov 3, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Kenneth Shawn McGuire

Title

President/Ceo

Phone

(408) 340-1568

Specialties & licenses 1

Addresses

Other names 1

• Children's Recovery Center Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Skilled nursing facility certification: CCN 555734

Legal name

CHILDRENS RECOVERY CENTER 1 LLC

Doing business as

CHILDRENS RECOVERY CENTER OF NORTHERN CALIFORNIA

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Mar 3, 1999

Last certification

Jul 26, 2024

Beds

27

Ownership / control type

Limited Liability Corporation

Most recent change of ownership

Jan 1, 2017

Organization structure

LLCProprietary

Incorporated

Oct 22, 2015 in CA

Enrollment address

3777 S Bascom Ave
Campbell, CA 95008-7320

Nursing home name

CHILDRENS HC ORG NO CA -PEDIATRIC HOSPITAL D/P SNF

Listed as

Childrens HC Org No Ca -Pediatric Hospital D/P SNFCCN 555734

Overall star rating

5 of 5

Health inspections

5 of 5

Quality measures

5 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Mar 3, 1999

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

2726.8 residents per day on average

Penalties (3 years)

1Fines totaling $3,145

Processed by Care Compare on Aug 1, 2026.

Tax ID family

Children'S Recovery Center3 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.

• Children'S Recovery Center 1, LLC

  • Children's Hospital
  • Campbell, CA
  • NPI 1720597511
  NPD tax ID
• Children'S Recovery Center, I LLC

  • Children's Hospital
  • Campbell, CA
  • NPI 1942335914
  NPD tax ID

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

• Children'S Recovery Center 2, LLC

  • Pediatric Skilled Nursing Facility
  • Saratoga, CA
  • NPI 1033219019

  Innovations Health Systems LLC

  CMS ownership

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486512000000",
    "number": "1114006830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3777 S. BASCOM AVE.",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "95008",
            "telephone_number": "408-340-1568",
            "fax_number": "408-866-8144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3777 S. BASCOM AVE.",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "95008",
            "telephone_number": "408-340-1568",
            "fax_number": "408-866-8144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S RECOVERY CENTER 1, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-03",
        "last_updated": "2017-02-08",
        "status": "A",
        "authorized_official_last_name": "MCGUIRE",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "SHAWN",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "408-340-1568",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282NC2000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Children",
            "state": "CA",
            "license": "070000320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Children's Recovery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Naomi Chernault, FNP
• Catherine Elizabeth Cherny, ASW
• Joyce Robin Chesnos, MA - MFT/AT
• Kellie Summer Cheves, RD
• Amy W CHI, OD
• Children'S Recovery Center 1, LLC
• Children'S Recovery Center, I LLC
• Jacqueline Olivia Childs
• Chiropractic Health Center Inc. a Delaware Corporation
• Chitra Shanmugham, D.D.S., Inc

• Children's Hospital in Campbell, CA
• Providers in Campbell, CA by specialty
• Children's Hospital in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.