NPIMap

Organization Active NPI

Antelope Valley Community Clinic

Doing business as Lancaster Adult Day Health Care

  • Federally Qualified Health Center (FQHC)
  • Lancaster, CA
National Provider Identifier
1245690387
Registry record updated Mar 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
550001452 Issued in CA
Legal business name
ANTELOPE VALLEY COMMUNITY CLINIC
Doing business as
Lancaster Adult Day Health Care
Practice address
45104 10TH St W
Lancaster, CA 93534-2310
Phone
(661) 942-2391
Fax
(661) 902-6839
NPI assigned
Mar 2, 2016
Last updated
Mar 2, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2016

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

Authorized official

Name
Ms. Teresa Roa
Title
Finance Specialist
Phone
(661) 942-2391

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 550001452 CA Primary

Addresses

Primary practice location

45104 10TH St W
Lancaster, CA 93534-2310

Mailing address

45104 10TH St W
Lancaster, CA 93534-2310
Phone (661) 942-2391

Other identifiers 1

IdentifierTypeStateIssuer
1730499872MedicaidCA

Other names 1

  • Lancaster Adult Day Health Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Lancaster Adult Day Health Care5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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": "1456876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456876800000",
    "number": "1245690387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45104 10TH ST W",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935342310",
            "telephone_number": "661-942-2391",
            "fax_number": "661-902-6839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45104 10TH ST W",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935342310",
            "telephone_number": "661-942-2391",
            "fax_number": "661-902-6839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTELOPE VALLEY COMMUNITY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-02",
        "last_updated": "2016-03-02",
        "status": "A",
        "authorized_official_last_name": "ROA",
        "authorized_official_first_name": "TERESA",
        "authorized_official_title_or_position": "FINANCE SPECIALIST",
        "authorized_official_telephone_number": "661-942-2391",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": "550001452",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1730499872",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lancaster Adult Day Health Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lancaster, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2016; 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.