NPIMap

Organization Active NPI

Central Neighborhood Health Foundation

  • Community Health Clinic/Center
  • Los Angeles, CA
National Provider Identifier
1639336803
Registry record updated Apr 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
License
550000352 Issued in CA
Legal business name
CENTRAL NEIGHBORHOOD HEALTH FOUNDATION
Practice address
2707 S Central Avenue
Los Angeles, CA 90011-5527
Phone
(323) 234-5000
Fax
(323) 231-3985
NPI assigned
May 16, 2008
Last updated
Apr 1, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2022

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

Authorized official

Name
Bassett H.L Brown, MD
Title
Ceo/President
Phone
(323) 234-5000

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care CoordinatorGroup: 193200000X MULTI-SPECIALTY GROUP 171M00000X
Case Management Agency 251B00000X
Supports Brokerage Agency 251X00000X
Community Health Clinic/Center 261QC1500X 550000352 CA Primary

Addresses

Primary practice location

2707 S Central Avenue
Los Angeles, CA 90011-5527

Mailing address

2707 S Central Ave
Los Angeles, CA 90011-5527
Phone (323) 234-5000

Other identifiers 1

IdentifierTypeStateIssuer
1639336803MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20101014000115 CA Part B Supplier - Clinic/Group Practice 4486846003 Receives reassigned benefits from 10 practitioners
Practice locations: Los Angeles, CA
O20130123000094 CA Part A Provider - Federally Qualified Health Center (FQHC) 4486846003 Practice locations: Los Angeles, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1639336803. Details of each certification follow.

Federally qualified health center certification: CCN 551198

Legal name
CENTRAL NEIGHBORHOOD HEALTH FOUNDATION
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 23, 2013
Last certification
Jan 23, 2013
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Incorporated
Jun 1, 2005 in CA
Enrollment address
2707 S Central Ave
Los Angeles, CA 90011-5527

National Provider Directory

National Provider Directory

Member organizations 4

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 7

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Crystal Lautrup Individual Corporate Director Sep 9, 2009
James Mackey Individual Corporate Director Feb 18, 2009
Eleanor Cochran Individual W-2 Managing Employee Mar 16, 2016
Operational/Managerial ControlChief of Operations Apr 1, 2018
Kenneth M. Orduna Individual 5% Or Greater Indirect Ownership Interest Dec 20, 2018
Corporate OfficerChief Executive Officer Dec 20, 2018 100%
W-2 Managing EmployeeChief Executive Officer Dec 20, 2018 100%
Richard Mayer Individual Corporate Director Feb 18, 2009
Mary McDonald Winners Individual Corporate Director Nov 18, 2010
Oscar Lopez Individual Corporate Director Oct 25, 2018

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
H Street ClinicSan Bernardino, CA, CCN 921153 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Nov 10, 2014
Nov 10, 2014
Central Neighborhood Health Foundation Inglewood ClinicInglewood, CA, CCN 921949 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Nov 10, 2014
Nov 10, 2014
Central Neighborhood Health Foundation-RiversideRiverside, CA, CCN 921893 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Nov 10, 2014
Nov 10, 2014
CNHF - CoachellaCoachella, CA, CCN A01046 Federally qualified health center Operational/Managerial Control Nov 1, 2017

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • H Street Clinic

    dba Central Neighborhood Health Foundation - Riverside

    • Federally Qualified Health Center (FQHC)
    • Riverside, CA
    • NPI 1447872577

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • H Street Clinic

    dba H Street Clinic Coachella

    • Federally Qualified Health Center (FQHC)
    • Coachella, CA
    • NPI 1528653482

    Operational/Managerial Control

    CMS ownership
  • H Street Clinic

    dba Central Neighborhood Health Foundation - Inglewood

    • Federally Qualified Health Center (FQHC)
    • Inglewood, CA
    • NPI 1548610322

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • H Street Clinic
    • Primary Care Clinic/Center
    • San Bernardino, CA
    • NPI 1841437241

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1210896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648771200000",
    "number": "1639336803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2707 S CENTRAL AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900115527",
            "telephone_number": "323-234-5000",
            "fax_number": "323-231-3985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2707 S CENTRAL AVENUE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900115527",
            "telephone_number": "323-234-5000",
            "fax_number": "323-231-3985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL NEIGHBORHOOD HEALTH FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-16",
        "last_updated": "2022-04-01",
        "certification_date": "2022-04-01",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "BASSETT",
        "authorized_official_middle_name": "H.L",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "323-234-5000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251X00000X",
            "taxonomy_group": "",
            "desc": "Supports Brokerage",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "CA",
            "license": "550000352",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1639336803",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.