St. Elizabeth Healthcare and Rehabilitation Center, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

060000114 Issued in CA

Legal business name

ST. ELIZABETH HEALTHCARE AND REHABILITATION CENTER, LLC

Doing business as

St. Elizabeth Healthcare and Rehabilitation Center

Practice address

2800 N Harbor Blvd
Fullerton, CA 92835-1727

Phone

(714) 871-9202

Fax

(714) 871-9677

NPI assigned

Feb 8, 2006

Last updated

Jan 27, 2016By the provider in NPPES

Organization subpart

Yes

Parent organization

SUMMIT CARE LLCAs reported in NPPES

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

Authorized official

Name

Michael T. Berg

Title

Assistant Secretary

Phone

(505) 468-4752

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• St. Elizabeth Healthcare and Rehabilitation Center Doing business as

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453852800000",
    "number": "1396718813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 N HARBOR BLVD",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928351727",
            "telephone_number": "714-871-9202",
            "fax_number": "714-871-9677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 N HARBOR BLVD",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928351727",
            "telephone_number": "714-871-9202",
            "fax_number": "714-871-9677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. ELIZABETH HEALTHCARE AND REHABILITATION CENTER, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUMMIT CARE LLC",
        "enumeration_date": "2006-02-08",
        "last_updated": "2016-01-27",
        "status": "A",
        "authorized_official_last_name": "BERG",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "505-468-4752"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "060000114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT05570J",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Elizabeth Healthcare and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Fullerton, CA
• Providers in Fullerton, 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 Jan 27, 2016; 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.