Geri-Care IV, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

920000122 Issued in CA

Legal business name

GERI-CARE IV, LLC

Doing business as

Antelope Valley Care Center

Practice address

44567 15TH St W
Lancaster, CA 93534-2803

Phone

(661) 949-5524

Fax

(661) 949-5140

NPI assigned

Nov 9, 2005

Last updated

Dec 19, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Richard L Terrell, MBA

Title

Administrator

Phone

(661) 949-5524

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Antelope Valley Care Center Doing business as

Locations

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324252800000",
    "number": "1609857275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44567 15TH ST W",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935342803",
            "telephone_number": "661-949-5524",
            "fax_number": "661-949-5140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44567 15TH ST W",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935342803",
            "telephone_number": "661-949-5524",
            "fax_number": "661-949-5140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GERI-CARE IV, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-09",
        "last_updated": "2011-12-19",
        "status": "A",
        "authorized_official_last_name": "TERRELL",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "661-949-5524",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "920000122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTM90003G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Antelope Valley Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Lancaster, CA
• Providers in Lancaster, CA by specialty
• Skilled Nursing Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2011; 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.