Community Convalescent Hospital of la Mesa LP

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

090000033 Issued in CA

Legal business name

COMMUNITY CONVALESCENT HOSPITAL OF LA MESA LP

Practice address

8665 La Mesa Blvd
La Mesa, CA 91941

Phone

(619) 465-0702

Fax

(619) 828-1782

NPI assigned

Oct 28, 2005

Last updated

Jul 25, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Jacob Graff

Title

President

Phone

(323) 556-0040

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1130457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532476800000",
    "number": "1225028327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8665 LA MESA BLVD",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919413903",
            "telephone_number": "619-465-0702",
            "fax_number": "619-828-1782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8665 LA MESA BLVD",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "91941",
            "telephone_number": "619-465-0702",
            "fax_number": "619-828-1782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CONVALESCENT HOSPITAL OF LA MESA LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-28",
        "last_updated": "2018-07-25",
        "status": "A",
        "authorized_official_last_name": "GRAFF",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-556-0040",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "090000033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT18070G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Drew Evan Collins, N.D.
• Kathleen Charlotte Collins, N.D.
• Claire C Collord Johnson, AUD
• Lauri Christine Combs, LCSW
• Theresa Mary Comito, MFT
• Community Dental Services (SmileCare Dental Group)
• Community Psych Nursing Partners Inc
• Robert C Conlin, DC
• Megan Conlon
• Chelsea Eva Connell, PMHNP - BC

• Skilled Nursing Facility in La Mesa, CA
• Providers in La Mesa, CA by specialty
• Skilled Nursing Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.