Active NPI
Imaginative Horizons Inc
- Skilled Nursing Facility
- National City, CA
National Provider Identifier
1255480646
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- IMAGINATIVE HORIZONS INC
- Practice address
- 1889 National City Blvd
National City, CA 91950-0000 - Phone
- (619) 477-1176
- Fax
- (619) 477-9933
- NPI assigned
- Jan 9, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Gary Byrnes
- Title
- Administrator
- Phone
- (619) 477-1176
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | CA | Primary |
Addresses
Primary practice location
1889 National City Blvd
National City, CA 91950-0000
Mailing address
1889 National City Blvd
National City, CA 91950-0000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZT05975G | Medicaid | CA |
Other names 1
- Hillcrest Manor Sanitarium
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080707000562 | CA | Part A Provider - Skilled Nursing Facility | 1850463951 | Practice locations: National City, CA |
Skilled nursing facility certification: CCN 055975
- Legal name
- IMAGINATIVE HORIZONS INC
- Doing business as
- HILLCREST MANOR SANITARIUM
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Sep 17, 1968
- Last certification
- Nov 21, 2024
- Beds
- 98
- Ownership / control type
- Corporation
- Organization structure
- Corporation
- Incorporated
- Aug 16, 1971 in CA
- Enrollment address
- 1889 National City Blvd
National City, CA 91950-5517 - Nursing home name
- HILLCREST MANOR SANITARIUM
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Hillcrest Manor Sanitarium
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Sep 17, 1968
- Medicare certification status
- Active
- Certified beds
- 98
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D0872419 | Hillcrest Manor Sanitarium | Certificate of waiver | Jun 29, 2027 |
National Provider Directory
National Provider DirectoryLocations
1889 National City Blvd
National City, CA 91950
Phone (619) 477-1176
Ownership & related parties
All disclosed owners & managing parties 1
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Maria Carmina Estacio | W-2 Managing Employee | May 7, 2008 |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168300800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1206316800000",
"number": "1255480646",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1889 NATIONAL CITY BLVD",
"city": "NATIONAL CITY",
"state": "CA",
"postal_code": "919500000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1889 NATIONAL CITY BLVD",
"city": "NATIONAL CITY",
"state": "CA",
"postal_code": "919500000",
"telephone_number": "619-477-1176",
"fax_number": "619-477-9933"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "IMAGINATIVE HORIZONS INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-09",
"last_updated": "2008-03-24",
"status": "A",
"authorized_official_last_name": "BYRNES",
"authorized_official_first_name": "GARY",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "619-477-1176"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "ZZT05975G",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Hillcrest Manor Sanitarium",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in National City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- 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.