Active NPI
Nic USA Inc
- Intellectual Disabilities Intermediate Care Facility
- Concord, CA
National Provider Identifier
1427183938
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual Disabilities Intermediate Care Facility
- Legal business name
- NIC USA INC
- Doing business as
- Happy Valley ICF DDH 1
- Practice address
- 3737 Barrington Dr
Concord, CA 94518 - Phone
- (925) 944-1222
- Fax
- (925) 946-9254
- NPI assigned
- Feb 23, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Costin Niculescu
- Title
- Executive Director
- Phone
- (925) 944-1222
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual Disabilities Intermediate Care Facility | 315P00000X | CA | Primary |
Addresses
Primary practice location
3737 Barrington Dr
Concord, CA 94518
Mailing address
2478 Warren LN
Walnut Creek, CA 94597
Phone (925) 944-1222
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LTC60710F | Medicaid | CA |
Other names 1
- Happy Valley ICF DDH 1
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Intermediate care facility for individuals with intellectual disabilities certification: CCN 05G954
Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.
- Legal name
- HAPPY VALLEY ICF DDH #2
- Certification status
- Active
- Provider type (POS)
- Intermediate care facility for individuals with intellectual disabilities
- Participating since
- Feb 26, 1996
- Last certification
- Dec 11, 2024
- Beds
- 6
- Ownership / control type
- Private (proprietary)
- Facility address
- 3737 Barrington Drive
Concord, CA 94518
National Provider Directory
National Provider Directory- Tax ID family
- Happy Valley Icf DDH 1
Other organizations with this tax ID 5
Organizations that report the same tax identification number in the National Provider Directory.
-
- Intellectual Disabilities Intermediate Care Facility
- Concord, CA
- NPI 1033244108
-
- Intellectual Disabilities Intermediate Care Facility
- Concord, CA
- NPI 1225173958
-
- Intellectual Disabilities Intermediate Care Facility
- Concord, CA
- NPI 1265567333
-
- Intellectual Disabilities Intermediate Care Facility
- Walnut Creek, CA
- NPI 1497890677
-
- Intellectual Disabilities Intermediate Care Facility
- Concord, CA
- NPI 1780729392
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172188800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1427183938",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2478 WARREN LN",
"city": "WALNUT CREEK",
"state": "CA",
"postal_code": "94597",
"telephone_number": "925-944-1222",
"fax_number": "925-946-9254"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3737 BARRINGTON DR",
"city": "CONCORD",
"state": "CA",
"postal_code": "94518",
"telephone_number": "925-944-1222",
"fax_number": "925-946-9254"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NIC USA INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-02-23",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "NICULESCU",
"authorized_official_first_name": "COSTIN",
"authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
"authorized_official_telephone_number": "925-944-1222"
},
"taxonomies": [
{
"code": "315P00000X",
"taxonomy_group": "",
"desc": "Intermediate Care Facility, Intellectual Disabilities",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "LTC60710F",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Happy Valley ICF DDH 1",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Concord, 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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.