NPIMap

Organization Active NPI

JWCH Institute, Inc.

  • Federally Qualified Health Center (FQHC)
  • Lynwood, CA
National Provider Identifier
1124182977
Registry record updated Feb 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
960000791 Issued in CA
Legal business name
JWCH INSTITUTE, INC.
Practice address
3591 E Imperial Hwy
Lynwood, CA 90262-2684
Phone
(310) 223-1035
Fax
(310) 638-9080
NPI assigned
Dec 19, 2006
Organization subpart
Yes
Parent organization
JWCH INSTITUTE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 1, 2022

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

Authorized official

Name
Mr. Alvaro P. Ballesteros
Title
Chief Executive Officer
Phone
(323) 201-4516

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care CoordinatorGroup: 193200000X MULTI-SPECIALTY GROUP 171M00000X
Supports Brokerage Agency 251X00000X
Community Health Clinic/Center 261QC1500X 960000791 CA
Federally Qualified Health Center (FQHC) 261QF0400X 960000791 CA Primary

Addresses

Primary practice location

3591 E Imperial Hwy
Lynwood, CA 90262-2684

Mailing address

5650 Jillson St
Commerce, CA 90040-1482
Phone (323) 201-4516

Other identifiers 1

IdentifierTypeStateIssuer
CMM70521FMedicaidCA

Other names 1

  • Wesley Health Center (Lynwood) Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20060807000476 CA Part B Supplier - Clinic/Group Practice 1850394123 Receives reassigned benefits from 160 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bellflower, CA; Downey, CA; Los Angeles, CA; Lynwood, CA; Norwalk, CA
O20100518000257 CA Part A Provider - Federally Qualified Health Center (FQHC) 1850394123 Practice locations: Lynwood, CA

Federally qualified health center certification: CCN 551045

Legal name
JWCH INSTITUTE INC
Doing business as
WESLEY HEALTH CENTER (LYNWOOD)
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 27, 2010
Last certification
May 27, 2010
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Incorporated
Mar 19, 1993 in CA
Enrollment address
3591 E Imperial Hwy
Lynwood, CA 90262-2654

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Wesley Health Centers - Michael Antonovich Dental Clinic

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Thomas Grode Individual Corporate DirectorBoard Member Jan 26, 2016
Leticia Ramirez Individual Operational/Managerial ControlClinic Administrator Apr 30, 1990 100%
Joseph Castel Individual Corporate DirectorBoard Member Jul 13, 2004
Andy Irie Individual Corporate OfficerCHF Admin Officer Jan 1, 2010 6.66%
Paul Gerald Gregerson Individual Corporate OfficerCHF Medical Officer Jan 1, 2001 6.66%
Jeanne Lam Individual Corporate OfficerChief Financial Officer Jul 1, 2005
Ronald Chambes Individual Corporate DirectorBoard Member Jun 13, 2007 6.66%
Alvaro P Ballesteros Individual Corporate OfficerCeo Oct 1, 2003 6.66%
Kathleen House Individual Corporate DirectorBoard Member Nov 22, 2011 6.66%
Silvia Hernandez Individual Corporate DirectorBoard Member Sep 23, 2014
Miguel a Naranjo Individual Corporate DirectorBoard Member Dec 14, 2012 6.66%
Lawrence Fernandez Individual Corporate DirectorBoard Member Jun 25, 2002
Maria a Padron Individual Corporate DirectorBoard Member Feb 14, 2007 6.66%
Robert Seymore Attiyeh Individual Corporate DirectorBoard Member Jun 23, 2015
Sheila Eaton Individual Corporate DirectorBoard Member Sep 24, 2013

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
JWCH Medical Clinic @ Bell ShelterBell, CA, CCN 751883 Federally qualified health center Operational/Managerial Control (100%) Jan 1, 2015
Wesley Health Centers - Palmdale CentralPalmdale, CA, CCN 921169 Federally qualified health center Operational/Managerial Control (100%) Apr 15, 2019

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643673600000",
    "number": "1124182977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5650 JILLSON ST",
            "city": "COMMERCE",
            "state": "CA",
            "postal_code": "900401482",
            "telephone_number": "323-201-4516",
            "fax_number": "323-215-0170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3591 E IMPERIAL HWY",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902622684",
            "telephone_number": "310-223-1035",
            "fax_number": "310-638-9080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JWCH INSTITUTE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JWCH INSTITUTE, INC.",
        "enumeration_date": "2006-12-19",
        "last_updated": "2022-02-01",
        "certification_date": "2022-02-01",
        "status": "A",
        "authorized_official_last_name": "BALLESTEROS",
        "authorized_official_first_name": "ALVARO",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "323-201-4516",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251X00000X",
            "taxonomy_group": "",
            "desc": "Supports Brokerage",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "CA",
            "license": "960000791",
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": "960000791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CMM70521F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wesley Health Center (Lynwood)",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Wesley Health Center (Lynwood)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lynwood, CA

Sources for this page

Verify at the official NPI Registry.