NPIMap

Organization Active NPI

Harbor Healthcare Inc

Doing business as Hoback Division

  • Intellectual Disabilities Intermediate Care Facility
  • Norwalk, CA
National Provider Identifier
1669509279
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
HARBOR HEALTHCARE INC
Doing business as
Hoback Division
Practice address
11262 Hoback St
Norwalk, CA 90650-3637
Phone
(562) 866-7054
Fax
(562) 867-8053
NPI assigned
Feb 28, 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
Mrs. Cheryl Loflin Wertz
Title
Ceo
Phone
(562) 866-7054

Specialties & licenses 1

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

Addresses

Primary practice location

11262 Hoback St
Norwalk, CA 90650-3637

Mailing address

16917 Clark Ave
Bellflower, CA 90706-5703
Phone (562) 866-7054

Other identifiers 1

IdentifierTypeStateIssuer
LTC60855GMedicaidCA

Other names 1

  • HOBACK DIVISION Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1669509279. Details of each certification follow.

  • CCN 55G180 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 55G180

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
HARBOR HEALTH C, INC - HOBACK DIVISION
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Mar 4, 1998
Last certification
May 29, 2025
Beds
6
Ownership / control type
Private (proprietary)
Facility address
11262 Hoback St
Norwalk, CA 90650

National Provider Directory

National Provider Directory
Tax ID family
Harbor Healthcare Inc19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

Organizations that report the same tax identification number in the National Provider Directory.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1669509279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16917 CLARK AVE",
            "city": "BELLFLOWER",
            "state": "CA",
            "postal_code": "907065703",
            "telephone_number": "562-866-7054",
            "fax_number": "562-867-8053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11262 HOBACK ST",
            "city": "NORWALK",
            "state": "CA",
            "postal_code": "906503637",
            "telephone_number": "562-866-7054",
            "fax_number": "562-867-8053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARBOR HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WERTZ",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "LOFLIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "562-866-7054",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC60855G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HOBACK DIVISION",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Norwalk, CA

Sources for this page

Verify at the official NPI Registry.