NPIMap

Organization Active NPI

United Care Providers-St Lucy

  • Intellectual Disabilities Intermediate Care Facility
  • Baldwin Park, CA
National Provider Identifier
1497726434
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
UNITED CARE PROVIDERS-ST LUCY
Practice address
4702 Cutler Ave
Baldwin Park, CA 91706-2425
Phone
(626) 814-1603
Fax
(626) 814-4483
NPI assigned
Jan 28, 2006
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
Adolfo J Festejo
Title
VP/Cfo
Phone
(818) 802-6303

Specialties & licenses 1

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

Addresses

Primary practice location

4702 Cutler Ave
Baldwin Park, CA 91706-2425

Mailing address

18409 Dancy St
Rowland Heights, CA 91748-4755
Phone (818) 802-6303

Other identifiers 1

IdentifierTypeStateIssuer
LTC80033FMedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
United Care Providers-Holy Infant4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1138406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497726434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18409 DANCY ST",
            "city": "ROWLAND HEIGHTS",
            "state": "CA",
            "postal_code": "917484755",
            "telephone_number": "818-802-6303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4702 CUTLER AVE",
            "city": "BALDWIN PARK",
            "state": "CA",
            "postal_code": "917062425",
            "telephone_number": "626-814-1603",
            "fax_number": "626-814-4483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED CARE PROVIDERS-ST LUCY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FESTEJO",
        "authorized_official_first_name": "ADOLFO",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "VP/CFO",
        "authorized_official_telephone_number": "818-802-6303"
    },
    "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": "LTC80033F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baldwin Park, 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.