NPIMap

Organization Active NPI

Jasmine Centers, Inc.

Doing business as Berryman House

  • Intellectual Disabilities Intermediate Care Facility
  • Culver City, CA
National Provider Identifier
1184827628
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
JASMINE CENTERS, INC.
Doing business as
Berryman House
Practice address
4915 Berryman Ave
Culver City, CA 90230-5111
Phone
(310) 397-7922
Fax
(310) 674-8282
NPI assigned
Jun 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Faye Annette Wiliams, PH.D.
Title
Ceo
Phone
(310) 674-8345

Specialties & licenses 1

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

Addresses

Primary practice location

4915 Berryman Ave
Culver City, CA 90230-5111

Mailing address

105 S Prairie Ave
Inglewood, CA 90301-1969
Phone (310) 674-8345

Other identifiers 1

IdentifierTypeStateIssuer
LTC60246FMedicaidCA

Other names 1

  • Berryman House Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Beach Avenue House3 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.

NPI Registry JSON

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1184827628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 S PRAIRIE AVE",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903011969",
            "telephone_number": "310-674-8345",
            "fax_number": "310-674-8282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4915 BERRYMAN AVE",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902305111",
            "telephone_number": "310-397-7922",
            "fax_number": "310-674-8282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JASMINE CENTERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILIAMS",
        "authorized_official_first_name": "FAYE",
        "authorized_official_middle_name": "ANNETTE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-674-8345",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC60246F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Berryman House",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Culver City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.