NPIMap

Organization Active NPI

Hacienda Grande

  • Psychiatric Residential Treatment Facility
  • Long Beach, CA
National Provider Identifier
1548415904
Registry record updated Nov 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X
License
198205024 Issued in CA
Legal business name
HACIENDA GRANDE
Practice address
1740 Grand Ave
Long Beach, CA 90804-2011
Phone
(562) 597-7753
Fax
(562) 597-7755
NPI assigned
Nov 25, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2008

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

Authorized official

Name
Mr. Rodrigo Ramos, RESIDENTIAL CARE
Title
Administrator Residential Care
Phone
(562) 597-7753

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Residential Treatment Facility 323P00000X 198205024 CA Primary

Addresses

Primary practice location

1740 Grand Ave
Long Beach, CA 90804-2011

Mailing address

1740 Grand Ave
Long Beach, CA 90804-2011
Phone (562) 597-7753

National Provider Directory

National Provider Directory
Tax ID family
Hacienda Grande2 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.

Locations

1740 Grand Ave
Long Beach, CA 90804
Phone (562) 597-7753

NPI Registry JSON

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

{
    "created_epoch": "1227571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1227571200000",
    "number": "1548415904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1740 GRAND AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908042011",
            "telephone_number": "562-597-7753",
            "fax_number": "562-597-7755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 GRAND AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908042011",
            "telephone_number": "562-597-7753",
            "fax_number": "562-597-7755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HACIENDA GRANDE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-25",
        "last_updated": "2008-11-25",
        "status": "A",
        "authorized_official_last_name": "RAMOS",
        "authorized_official_first_name": "RODRIGO",
        "authorized_official_title_or_position": "ADMINISTRATOR RESIDENTIAL CARE",
        "authorized_official_telephone_number": "562-597-7753",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RESIDENTIAL CARE"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "CA",
            "license": "198205024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 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.