Harvest Moon Intermediate Care Facility- Nursing

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

960001418 Issued in CA

Legal business name

HARVEST MOON INTERMEDIATE CARE FACILITY- NURSING

Practice address

1017 E Harvest Moon St
West Covina, CA 91792-1023

Phone

(626) 961-0076

Fax

(626) 961-0076

NPI assigned

Jun 27, 2008

Organization subpart

No

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

Authorized official

Name

Ms. Yolie Crume, RN

Title

Administrator

Phone

(626) 551-7379

Specialties & licenses 1

Addresses

Tax ID family

Carequest2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Harvestmoon Icfddn

  • Nursing Facility/Intermediate Care Facility
  • West Covina, CA
  • NPI 1295937415
  NPD tax ID

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

{
    "created_epoch": "1214524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214524800000",
    "number": "1396907663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1017 E HARVEST MOON ST",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917921023",
            "telephone_number": "626-961-0076",
            "fax_number": "626-961-0076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1017 E HARVEST MOON ST",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917921023",
            "telephone_number": "626-961-0076",
            "fax_number": "626-961-0076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARVEST MOON INTERMEDIATE CARE FACILITY- NURSING",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-27",
        "last_updated": "2008-06-27",
        "status": "A",
        "authorized_official_last_name": "CRUME",
        "authorized_official_first_name": "YOLIE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "626-551-7379",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "CA",
            "license": "960001418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fredreece Harrison
• Harry a. Louie, D.D.S., Apc
• Harry E Confer DPM a Professional Corp
• Harry E Confer, DPM Inc
• Sarah Hart
• Harvestmoon Icfddn
• Elizabeth Harvey
• Joy Elizabeth Hass
• Galal Hassaballa, RPH
• Majid Hassan, MD

• Nursing Facility/Intermediate Care Facility in West Covina, CA
• Providers in West Covina, CA by specialty
• Nursing Facility/Intermediate Care Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2008; 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.