Centennial Healthcare LLC

Primary specialty

Pediatric Skilled Nursing FacilityTaxonomy code 3140N1450X

License

550000738 Issued in CA

Legal business name

CENTENNIAL HEALTHCARE LLC

Doing business as

gateway homes

Practice address

7504 Capps Ave
Reseda, CA 91335-2710

Phone

(818) 881-1182

Fax

(562) 268-1608

NPI assigned

Jun 11, 2014

Last updated

Jun 11, 2014By 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

Harry Jacobs

Title

Manager

Phone

(818) 881-1182

Specialties & licenses 1

Addresses

Other names 1

• gateway homes Doing business as

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

{
    "created_epoch": "1402444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402444800000",
    "number": "1669886230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7504 CAPPS AVE",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913352710",
            "telephone_number": "818-881-1182",
            "fax_number": "562-268-1608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7504 CAPPS AVE",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913352710",
            "telephone_number": "818-881-1182",
            "fax_number": "562-268-1608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTENNIAL HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-11",
        "last_updated": "2014-06-11",
        "status": "A",
        "authorized_official_last_name": "JACOBS",
        "authorized_official_first_name": "HARRY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "818-881-1182"
    },
    "taxonomies": [
        {
            "code": "3140N1450X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility, Nursing Care, Pediatric",
            "state": "CA",
            "license": "550000738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "gateway homes",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pediatric Skilled Nursing Facility in Reseda, CA
• Providers in Reseda, CA by specialty
• Pediatric Skilled Nursing Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2014; 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.