Lone Pine Health Care LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

LONE PINE HEALTH CARE LLC

Doing business as

Valencia Palms

Practice address

82262 Valencia Ave
Indio, CA 92201-3120

Phone

(760) 347-6000

Fax

(760) 755-6828

NPI assigned

Sep 7, 2005

Organization subpart

No

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

Authorized official

Name

Jeffery Blaine Hendrickson

Title

President

Phone

(760) 347-0750

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Valencia Palms Doing business as

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

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1255325056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10487",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924230487",
            "telephone_number": "909-885-0268",
            "fax_number": "909-884-1722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82262 VALENCIA AVE",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922013120",
            "telephone_number": "760-347-6000",
            "fax_number": "760-755-6828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONE PINE HEALTH CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HENDRICKSON",
        "authorized_official_first_name": "JEFFERY",
        "authorized_official_middle_name": "BLAINE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-347-0750"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT05278J",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Valencia Palms",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Indio, CA
• Providers in Indio, 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 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.