NPIMap

Organization Active NPI

Country Crest, LLC

Doing business as Country Crest Post Acute

  • Skilled Nursing Facility
  • Oroville, CA
National Provider Identifier
1255690079
Registry record updated Mar 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
230000351 Issued in CA
Legal business name
COUNTRY CREST, LLC
Doing business as
Country Crest Post Acute
Practice address
50 Concordia Lane
Oroville, CA 95966
Phone
(530) 533-7857
Fax
(530) 533-7887
NPI assigned
May 14, 2012
Last updated
Mar 10, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2014

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

Authorized official

Name
Mr. Ryan O'Hara
Title
Cfo
Phone
(888) 309-0022

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU
Skilled Nursing Facility 314000000X 230000351 CA Primary

Addresses

Primary practice location

50 Concordia Lane
Oroville, CA 95966

Mailing address

530 N. Puente Street
Brea, CA 92821
Phone (530) 533-7857

Other names 1

  • Country Crest Post Acute Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1336953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394409600000",
    "number": "1255690079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 N. PUENTE STREET",
            "city": "BREA",
            "state": "CA",
            "postal_code": "92821",
            "telephone_number": "530-533-7857",
            "fax_number": "530-533-7887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 CONCORDIA LANE",
            "city": "OROVILLE",
            "state": "CA",
            "postal_code": "95966",
            "telephone_number": "530-533-7857",
            "fax_number": "530-533-7887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTRY CREST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-14",
        "last_updated": "2014-03-10",
        "status": "A",
        "authorized_official_last_name": "O'HARA",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "888-309-0022",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "230000351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Country Crest Post Acute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oroville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2014; 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.