NPIMap

Organization Active NPI

Safe Harbor Residential Services, Inc.

  • Intellectual Disabilities Intermediate Care Facility
  • Hanford, CA
National Provider Identifier
1336361435
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
SAFE HARBOR RESIDENTIAL SERVICES, INC.
Practice address
2887 N Douty St
Hanford, CA 93230-1224
Phone
(559) 582-7441
Fax
(559) 584-8674
NPI assigned
May 2, 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
Ms. Gwendolyn M. Smith
Title
Administrator
Phone
(559) 589-6000

Specialties & licenses 1

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

Addresses

Primary practice location

2887 N Douty St
Hanford, CA 93230-1224

Mailing address

PO Box 163
318-A E. 4TH Steet
Hanford, CA 93232-0163
Phone (559) 589-6000

Other identifiers 1

IdentifierTypeStateIssuer
LTC60622GOtherCAMEDICAL PROVIDER NUMBER

Other names 1

  • Safe Harbor Residential - Douty Other name

National Provider Directory

National Provider Directory
Tax ID family
Safe Harbor Residential - Birch4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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": "1178064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1336361435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 163",
            "address_2": "318-A E. 4TH STEET",
            "city": "HANFORD",
            "state": "CA",
            "postal_code": "932320163",
            "telephone_number": "559-589-6000",
            "fax_number": "559-584-8674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2887 N DOUTY ST",
            "city": "HANFORD",
            "state": "CA",
            "postal_code": "932301224",
            "telephone_number": "559-582-7441",
            "fax_number": "559-584-8674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAFE HARBOR RESIDENTIAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "GWENDOLYN",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "559-589-6000",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL PROVIDER NUMBER",
            "identifier": "LTC60622G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Safe Harbor Residential - Douty",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Hanford, CA

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.