NPIMap

Organization Active NPI

Northern California Adaptive Living Center, Inc.

  • Intellectual Disabilities Intermediate Care Facility
  • Ukiah, CA
National Provider Identifier
1578779286
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
NORTHERN CALIFORNIA ADAPTIVE LIVING CENTER, INC.
Practice address
1116 W Perkins St
Ukiah, CA 95482-4625
Phone
(707) 468-0602
Fax
(707) 468-3854
NPI assigned
May 16, 2007
Last updated
Aug 22, 2020By the provider in NPPES
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
Susan C Kolar
Title
Executive Director
Phone
(530) 894-2726

Specialties & licenses 1

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

Addresses

Primary practice location

1116 W Perkins St
Ukiah, CA 95482-4625

Mailing address

3028 Esplanade
Suite H
Chico, CA 95973-4924
Phone (530) 894-2726

Other identifiers 1

IdentifierTypeStateIssuer
LTC60260GOtherCAMEDI-CAL

Other names 1

  • Lakeview Facility Other name

National Provider Directory

National Provider Directory
Tax ID family
Northern California Adaptive Living Center Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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": "1179273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1578779286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3028 ESPLANADE",
            "address_2": "SUITE H",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959734924",
            "telephone_number": "530-894-2726",
            "fax_number": "530-894-2798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1116 W PERKINS ST",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954824625",
            "telephone_number": "707-468-0602",
            "fax_number": "707-468-3854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN CALIFORNIA ADAPTIVE LIVING CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KOLAR",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "530-894-2726"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "LTC60260G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeview Facility",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Ukiah, 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.