NPIMap

Organization Active NPI

G & R Alameda Healthcare Services, LLC

  • Skilled Nursing Facility
  • Alameda, CA
National Provider Identifier
1114119054
Registry record updated Nov 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
G & R ALAMEDA HEALTHCARE SERVICES, LLC
Doing business as
Crown Bay Nursing and Rehabilitation Center
Practice address
508 Westline Dr
Alameda, CA 94501-5847
Phone
(510) 521-5765
Fax
(510) 521-1977
NPI assigned
Aug 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2015

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

Authorized official

Name
Mr. Tony Agoncillo
Title
Finance Manager
Phone
(626) 304-6900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

508 Westline Dr
Alameda, CA 94501-5847

Mailing address

445 S Fair Oaks Ave
Pasadena, CA 91105-2632
Phone (626) 304-6900

Other identifiers 1

IdentifierTypeStateIssuer
ZZR06103HMedicaidCA

Other names 1

  • Crown Bay Nursing and Rehabilitation Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071101000075 CA Part A Provider - Skilled Nursing Facility 3870680234 Practice locations: Alameda, CA

Skilled nursing facility certification: CCN 056103

Legal name
G & R ALAMEDA HEALTHCARE SERVICES, LLC
Doing business as
CROWN BAY NURSING AND REHABILITATION
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Aug 1, 1974
Last certification
Aug 10, 2023
Beds
151
Ownership / control type
Limited Liability Corporation
Multi-facility organization
G R Alameda Healthcare Services LLC
Organization structure
LLCProprietary
Incorporated
Aug 3, 2007 in CA
Enrollment address
508 Westline Dr
Alameda, CA 94501-5847
Nursing home name
WEST SHORE POST ACUTE

Care Compare: Nursing home

Medicare Care Compare
Listed as
West Shore Post AcuteCCN 056103 · All quality measures
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
3 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Aug 1, 1974
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
151130.2 residents per day on average

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Grace S Mercado Individual 5% Or Greater Direct Ownership InterestConsultative Aug 3, 2007 95%
Corporate OfficerManager Aug 3, 2007
Operational/Managerial Control Aug 3, 2007 95%
Yolanda L Sambile Individual Corporate OfficerManager Jul 25, 2011
Ruperto V Ouano Individual 5% Or Greater Direct Ownership Interest Aug 3, 2007 5%
Saint Cabrini Healthcare Services LLC Organization, Pasadena, CA LLC Operational/Managerial Control Aug 31, 2007

Practitioners & affiliated clinicians

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1187049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447891200000",
    "number": "1114119054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 S FAIR OAKS AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911052632",
            "telephone_number": "626-304-6900",
            "fax_number": "626-564-2617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 WESTLINE DR",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945015847",
            "telephone_number": "510-521-5765",
            "fax_number": "510-521-1977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "G & R ALAMEDA HEALTHCARE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-14",
        "last_updated": "2015-11-19",
        "status": "A",
        "authorized_official_last_name": "AGONCILLO",
        "authorized_official_first_name": "TONY",
        "authorized_official_title_or_position": "FINANCE MANAGER",
        "authorized_official_telephone_number": "626-304-6900",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZR06103H",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crown Bay Nursing and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Alameda, CA

Sources for this page

Verify at the official NPI Registry.