NPIMap

Organization Active NPI

Greenfields Intermediate Care Facility

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Vallejo, CA
National Provider Identifier
1295945244
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
Legal business name
GREENFIELDS INTERMEDIATE CARE FACILITY
Practice address
219 Torrey Pines CT
Vallejo, CA 94591-4333
Phone
(707) 558-8149
Fax
(707) 644-9483
NPI assigned
May 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
Teresita Reyes, RN
Title
Administrator
Phone
(707) 553-2935

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X CA Primary

Addresses

Primary practice location

219 Torrey Pines CT
Vallejo, CA 94591-4333

Mailing address

219 Torrey Pines CT
Vallejo, CA 94591-4333
Phone (707) 558-8149

Other names 1

  • GREENFIELDS I ICF-DDN 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 55G133

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
GREENFIELDS I ICF-DDN
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Oct 3, 1997
Last certification
Apr 23, 2025
Beds
6
Ownership / control type
Private (proprietary)
Facility address
219 Torrey Pines Court
Vallejo, CA 94591

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0987253Greenfields I Icf DDN219 Torrey Pines Street, Vallejo, CA 94591Certificate of waiverMay 30, 2027

National Provider Directory

National Provider Directory
Tax ID family
Greenfields Intemediate Care Facility6 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": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295945244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 TORREY PINES CT",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945914333",
            "telephone_number": "707-558-8149",
            "fax_number": "707-644-9483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 TORREY PINES CT",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945914333",
            "telephone_number": "707-558-8149",
            "fax_number": "707-644-9483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENFIELDS INTERMEDIATE CARE FACILITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "REYES",
        "authorized_official_first_name": "TERESITA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "707-553-2935",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GREENFIELDS I ICF-DDN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vallejo, CA

Sources for this page

Verify at the official NPI Registry.