NPIMap

Organization Active NPI

Nic USA Inc

  • Intellectual Disabilities Intermediate Care Facility
  • Concord, CA
National Provider Identifier
1265567333
Registry record updated Aug 22, 2020
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Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
NIC USA INC
Doing business as
Happy Valley ICF DDH 3
Practice address
4118 Phoenix St
Concord, CA 94521
Phone
(925) 944-1222
Fax
(925) 946-9254
NPI assigned
Feb 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Costin Niculescu
Title
Executive Director
Phone
(925) 944-1222

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X CA Primary

Addresses

Primary practice location

4118 Phoenix St
Concord, CA 94521

Mailing address

2478 Warren LN
Walnut Creek, CA 94597
Phone (925) 944-1222

Other identifiers 1

IdentifierTypeStateIssuer
LTC60777FMedicaidCA

Other names 1

  • Happy Valley ICF DDH 3 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Intermediate care facility for individuals with intellectual disabilities certification: CCN 55G062

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
HAPPY VALLEY #3
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Jan 31, 1997
Last certification
Nov 20, 2025
Beds
6
Ownership / control type
Private (proprietary)
Most recent change of ownership
May 6, 2009
Facility address
4118 Phoenix Street
Concord, CA 94521

National Provider Directory

National Provider Directory
Tax ID family
Happy Valley Icf DDH 16 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1265567333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2478 WARREN LN",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "94597",
            "telephone_number": "925-944-1222",
            "fax_number": "925-946-9254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4118 PHOENIX ST",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "94521",
            "telephone_number": "925-944-1222",
            "fax_number": "925-946-9254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NIC USA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NICULESCU",
        "authorized_official_first_name": "COSTIN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "925-944-1222",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC60777F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Happy Valley ICF DDH 3",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Concord, CA

Sources for this page

Verify at the official NPI Registry.