NPIMap

Organization Active NPI

Angel View Crippled Childrens Foundation Inc

Doing business as Glenda Shaklee House

  • Intellectual Disabilities Intermediate Care Facility
  • Joshua Tree, CA
National Provider Identifier
1295872067
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
ANGEL VIEW CRIPPLED CHILDRENS FOUNDATION INC
Doing business as
Glenda Shaklee House
Practice address
60950 Sunburst
Joshua Tree, CA 92252
Phone
(760) 329-6471
NPI assigned
Jan 31, 2007
Last updated
Aug 22, 2020By the provider in NPPES
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. David C Thornton
Title
Executive Director
Phone
(760) 329-6471

Specialties & licenses 1

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

Addresses

Primary practice location

60950 Sunburst
Joshua Tree, CA 92252

Mailing address

12379 Miracle Hill Road
Desert Hot Springs, CA 92240-4010
Phone (760) 329-6471

Other names 1

  • Glenda Shaklee House Doing business as

Medicare participation

Medicare enrollment files
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 1295872067. Details of each certification follow.

  • CCN 05G935 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 05G935

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
GLENDA SHAKLEE HOUSE
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Dec 5, 1995
Last certification
May 30, 2019
Beds
6
Ownership / control type
Private (non-profit)
Facility address
60950 Sunburst
Joshua Tree, CA 92252

National Provider Directory

National Provider Directory
Tax ID family
Angel View Crippled Childrens Foundation Inc21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

Organizations that report the same tax identification number in the National Provider Directory.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295872067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12379 MIRACLE HILL ROAD",
            "city": "DESERT HOT SPRINGS",
            "state": "CA",
            "postal_code": "922404010",
            "telephone_number": "760-329-6471",
            "fax_number": "760-329-9024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60950 SUNBURST",
            "city": "JOSHUA TREE",
            "state": "CA",
            "postal_code": "92252",
            "telephone_number": "760-329-6471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGEL VIEW CRIPPLED CHILDRENS FOUNDATION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "THORNTON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "760-329-6471",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Glenda Shaklee House",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Joshua Tree, CA

Sources for this page

Verify at the official NPI Registry.