NPIMap

Organization Active NPI

Harbor Healthcare Inc

  • Intellectual Disabilities Intermediate Care Facility
  • Cerritos, CA
National Provider Identifier
1356478093
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
HARBOR HEALTHCARE INC
Practice address
17746 Antonio Ave
Cerritos, CA 90703-8822
Phone
(562) 866-7054
Fax
(562) 867-8053
NPI assigned
Feb 28, 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
Mrs. Cheryl Loflin Wertz
Title
Ceo
Phone
(562) 866-7054

Specialties & licenses 1

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

Addresses

Primary practice location

17746 Antonio Ave
Cerritos, CA 90703-8822

Mailing address

16917 Clark Ave
Bellflower, CA 90706-5703
Phone (562) 866-7054

Other identifiers 1

IdentifierTypeStateIssuer
LTC60108IMedicaidCA

Other names 1

  • ANTONIO DIVISION Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Harbor Healthcare Inc19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356478093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16917 CLARK AVE",
            "city": "BELLFLOWER",
            "state": "CA",
            "postal_code": "907065703",
            "telephone_number": "562-866-7054",
            "fax_number": "562-867-8053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17746 ANTONIO AVE",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907038822",
            "telephone_number": "562-866-7054",
            "fax_number": "562-867-8053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARBOR HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WERTZ",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "LOFLIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "562-866-7054",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC60108I",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ANTONIO DIVISION",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cerritos, 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.