NPIMap

Organization Active NPI

Mouri Management Group Incorporated

Doing business as Shinrai Homes

  • Intellectual Disabilities Intermediate Care Facility
  • San Jose, CA
National Provider Identifier
1205987864
Registry record updated Oct 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
MOURI MANAGEMENT GROUP INCORPORATED
Doing business as
Shinrai Homes
Practice address
5601 Croydon Ave
San Jose, CA 95118-3522
Phone
(408) 267-2109
Fax
(408) 531-9020
NPI assigned
Jan 12, 2007
Last updated
Oct 25, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2023

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

Authorized official

Name
Noel De Jesus
Title
Executive Director
Phone
(408) 531-9126

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X NU Primary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X LTC60949F CA

Addresses

Primary practice location

5601 Croydon Ave
San Jose, CA 95118-3522

Mailing address

3220 Flintdale Drive
San Jose, CA 95148-1231
Phone (408) 531-9126

Other names 1

  • Shinrai Homes Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1205987864. Details of each certification follow.

  • CCN 55G331 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 55G331

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
SHINRAI-CROYDON
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Jul 14, 2000
Last certification
Feb 12, 2026
Beds
6
Ownership / control type
Private (proprietary)
Facility address
5601 Croydon Avenue
San Jose, CA 95118

National Provider Directory

National Provider Directory
Tax ID family
Mouri Management Group Incorporated6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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": "1168560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698192000000",
    "number": "1205987864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3220 FLINTDALE DRIVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951481231",
            "telephone_number": "408-531-9126",
            "fax_number": "408-531-9020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 CROYDON AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951183522",
            "telephone_number": "408-267-2109",
            "fax_number": "408-531-9020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOURI MANAGEMENT GROUP INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-12",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A",
        "authorized_official_last_name": "DE JESUS",
        "authorized_official_first_name": "NOEL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "408-531-9126"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "CA",
            "license": "LTC60949F",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shinrai Homes",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.