President John Adams Manor III

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

Legal business name

PRESIDENT JOHN ADAMS MANOR III

Practice address

5701 Falconer Way
Sacramento, CA 95824-1517

Phone

(916) 417-3481

Fax

(916) 927-4370

NPI assigned

Apr 18, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lori Worthen

Title

Cfo

Phone

(916) 417-3481

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1265658892. Details of each certification follow.

• CCN 05G836 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 05G836

Legal name

PRESIDENT JOHN ADAMS MANOR III - FALCONER

Certification status

Active

Provider type (POS)

Intermediate care facility for individuals with intellectual disabilities

Participating since

Jan 30, 1995

Last certification

Dec 17, 2025

Beds

14

Ownership / control type

Private (non-profit)

Facility address

5701 Falconer Way
Sacramento, CA 95824

Locations

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1265658892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5701 FALCONER WAY",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958241517",
            "telephone_number": "916-417-3481",
            "fax_number": "916-927-4370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 FALCONER WAY",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958241517",
            "telephone_number": "916-417-3481",
            "fax_number": "916-927-4370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESIDENT JOHN ADAMS MANOR III",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WORTHEN",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "916-417-3481"
    },
    "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": "LTC60643F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Preparing People for Success
• Preparing People for Success
• Preparingpeopleforsuccess
• Alison Prescott
• Pamela Prescott, MD
• Jeremiah Presinal
• Michael H Preskar, D.D.S.
• Ethan Preslar
• Cinae Presley
• Marcellus Andrew Presley

• Intellectual Disabilities Intermediate Care Facility in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Intellectual Disabilities Intermediate Care 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.