Organization Active NPI

Grancare LLC

  • Skilled Nursing Facility
  • Glendale, CA
National Provider Identifier
1659343192
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
GRANCARE LLC
Practice address
430 N Glendale Ave
Glendale, CA 91206-3309
Phone
(818) 246-5677
NPI assigned
Feb 7, 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
Mrs. Andrea Saavedra
Title
Regional Financial Analyst
Phone
(707) 208-1940

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X CA Primary

Addresses

Primary practice location

430 N Glendale Ave
Glendale, CA 91206-3309

Mailing address

430 N Glendale Ave
Glendale, CA 91206-3309
Phone (818) 246-5677

Other identifiers 1

IdentifierTypeStateIssuer
ZZT05288IMedicaidCA

Other names 1

  • Autumn Hills Healthcare Center Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1659343192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 N GLENDALE AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912063309",
            "telephone_number": "818-246-5677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 N GLENDALE AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912063309",
            "telephone_number": "818-246-5677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SAAVEDRA",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "REGIONAL FINANCIAL ANALYST",
        "authorized_official_telephone_number": "707-208-1940",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT05288I",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Autumn Hills Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glendale, 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.