Mutual Care Management, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

250000135 Issued in CA

Legal business name

MUTUAL CARE MANAGEMENT, INC.

Doing business as

Same

Practice address

9025 Colorado Ave
Riverside, CA 92503-2157

Phone

(951) 688-3636

Fax

(951) 688-3031

NPI assigned

May 31, 2007

Last updated

May 14, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Gretchen Reynolds, RN

Title

Administrator

Phone

(951) 688-3636

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• SAME Doing business as

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273795200000",
    "number": "1366643603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9025 COLORADO AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925032157",
            "telephone_number": "951-688-3636",
            "fax_number": "951-688-3031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9025 COLORADO AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925032157",
            "telephone_number": "951-688-3636",
            "fax_number": "951-688-3031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUTUAL CARE MANAGEMENT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-31",
        "last_updated": "2010-05-14",
        "status": "A",
        "authorized_official_last_name": "REYNOLDS",
        "authorized_official_first_name": "GRETCHEN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "951-688-3636",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "250000135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1770690034",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC06315F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SAME",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Riverside, CA
• Providers in Riverside, CA by specialty
• Skilled Nursing Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2010; 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.