Active NPI
Bayberry House
- Intellectual Disabilities Intermediate Care Facility
- Napa, CA
National Provider Identifier
1174705891
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual Disabilities Intermediate Care Facility
- Legal business name
- BAYBERRY HOUSE
- Practice address
- 400 Aguirre Way
Napa, CA 94559-3551 - Phone
- (707) 252-6733
- NPI assigned
- Dec 4, 2007
- Organization subpart
- Yes
- Parent organization
- BAYBERRY, INCORPORATED
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Linda Washington
- Title
- Ceo
- Phone
- (707) 252-6845
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual Disabilities Intermediate Care Facility | 315P00000X | Primary |
Addresses
Primary practice location
400 Aguirre Way
Napa, CA 94559-3551
Mailing address
1700 2ND St Ste 350
Napa, CA 94559-2409
Phone (707) 252-6845
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LTC60052F | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Intermediate care facility for individuals with intellectual disabilities certification: CCN 05G095
Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.
- Legal name
- BAYBERRY HOUSE
- Certification status
- Active
- Provider type (POS)
- Intermediate care facility for individuals with intellectual disabilities
- Participating since
- Jun 3, 1983
- Last certification
- Aug 7, 2024
- Beds
- 6
- Ownership / control type
- Private (non-profit)
- Facility address
- 400 Aguirre Way
Napa, CA 94559
National Provider Directory
National Provider Directory- Tax ID family
- Bayberry House
- Part of
- Bayberry House
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Intellectual Disabilities Intermediate Care Facility
- Napa, CA
- NPI 1346422060
Locations
1700 2nd St
Ste 350
Napa, CA 94559
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196726400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1333324800000",
"number": "1174705891",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1700 2ND ST STE 350",
"city": "NAPA",
"state": "CA",
"postal_code": "945592409",
"telephone_number": "707-252-6845"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 AGUIRRE WAY",
"city": "NAPA",
"state": "CA",
"postal_code": "945593551",
"telephone_number": "707-252-6733"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BAYBERRY HOUSE",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "BAYBERRY, INCORPORATED",
"enumeration_date": "2007-12-04",
"last_updated": "2012-04-02",
"status": "A",
"authorized_official_last_name": "WASHINGTON",
"authorized_official_first_name": "LINDA",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "707-252-6845"
},
"taxonomies": [
{
"code": "315P00000X",
"taxonomy_group": "",
"desc": "Intermediate Care Facility, Intellectual Disabilities",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "LTC60052F",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Napa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2012; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.