NPIMap

Organization Active NPI

Harvestmoon Icfddn

  • Nursing Facility/Intermediate Care Facility
  • West Covina, CA
National Provider Identifier
1295937415
Registry record updated Jun 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
License
960001418 Issued in CA
Legal business name
HARVESTMOON ICFDDN
Practice address
1017 E Harvest Moon St
West Covina, CA 91792-1023
Phone
(626) 665-8938
Fax
(925) 516-7106
NPI assigned
Jun 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2008

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

Authorized official

Name
Ms. Yolie Crume, R.N.
Title
Administrator-Owner
Phone
(626) 665-8938

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X 960001418 CA Primary

Addresses

Primary practice location

1017 E Harvest Moon St
West Covina, CA 91792-1023

Mailing address

1017 E Harvest Moon St
West Covina, CA 91792-1023
Phone (626) 665-8938

Other names 1

  • Carequest Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Carequest2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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": "1180656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213833600000",
    "number": "1295937415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1017 E HARVEST MOON ST",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917921023",
            "telephone_number": "626-665-8938",
            "fax_number": "925-516-7106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1017 E HARVEST MOON ST",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917921023",
            "telephone_number": "626-665-8938",
            "fax_number": "925-516-7106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARVESTMOON ICFDDN",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-01",
        "last_updated": "2008-06-19",
        "status": "A",
        "authorized_official_last_name": "CRUME",
        "authorized_official_first_name": "YOLIE",
        "authorized_official_title_or_position": "ADMINISTRATOR-OWNER",
        "authorized_official_telephone_number": "626-665-8938",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "CA",
            "license": "960001418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carequest",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Covina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2008; 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.