NPIMap

Organization Active NPI

Davidson Adult Home / Brookdale Dr

  • Intellectual Disabilities Intermediate Care Facility
  • Merced, CA
National Provider Identifier
1184811895
Registry record updated Sep 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
LTC80038F Issued in CA
Legal business name
DAVIDSON ADULT HOME / BROOKDALE DR
Practice address
1326 Brookdale Dr
Merced, CA 95340-1639
Phone
(209) 384-7402
Fax
(209) 383-1538
NPI assigned
Sep 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2007

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

Authorized official

Name
Mrs. Julie Davidson, RN
Title
Owner
Phone
(209) 384-7402

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X LTC80038F CA Primary

Addresses

Primary practice location

1326 Brookdale Dr
Merced, CA 95340-1639

Mailing address

PO Box 332
Merced, CA 95341-0332
Phone (209) 384-7402

National Provider Directory

National Provider Directory
Tax ID family
Davidson Adult Home Brookdale Dr2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1190764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190764800000",
    "number": "1184811895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 332",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953410332",
            "telephone_number": "209-384-7402",
            "fax_number": "209-383-1538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1326 BROOKDALE DR",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953401639",
            "telephone_number": "209-384-7402",
            "fax_number": "209-383-1538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVIDSON ADULT HOME / BROOKDALE DR",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-26",
        "last_updated": "2007-09-26",
        "status": "A",
        "authorized_official_last_name": "DAVIDSON",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "209-384-7402",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "CA",
            "license": "LTC80038F",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merced, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2007; 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.