Organization Active NPI

Bluff Enterprises Corp

  • Skilled Nursing Facility
  • Folsom, CA
National Provider Identifier
1679505572
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
030000040 Issued in CA
Legal business name
BLUFF ENTERPRISES CORP
Doing business as
Folsom Care Center
Folsom Convalescent Hospital
Practice address
510 Mill St
Folsom, CA 95630-2607
Phone
(916) 985-3641
Fax
(916) 985-7231
NPI assigned
Jul 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

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

Authorized official

Name
Calvin Wade Callaway
Title
Administrator
Phone
(916) 985-3641

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 030000040 CA Primary

Addresses

Primary practice location

510 Mill St
Folsom, CA 95630-2607

Mailing address

510 Mill St
Folsom, CA 95630-2607
Phone (916) 985-3641

Other identifiers 1

IdentifierTypeStateIssuer
ZZR05173FMedicaidCA

Other names 2

  • Folsom Care Center Doing business as
  • Folsom Convalescent Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120427000505 CA Part A Provider - Skilled Nursing Facility 7810159472 Practice locations: Folsom, CA

Skilled nursing facility certification: CCN 055173

Legal name
BLUFF ENTERPRISES CORP
Doing business as
FOLSOM CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 1, 1967
Last certification
Feb 14, 2025
Beds
99
Ownership / control type
Corporation
Organization structure
CorporationProprietary
Incorporated
Feb 16, 1965 in CA
Enrollment address
510 Mill St
Folsom, CA 95630-2607
Nursing home name
FOLSOM CARE CENTER

Care Compare: Nursing home

Medicare Care Compare
Listed as
Folsom Care CenterCCN 055173 · All quality measures
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
5 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jan 1, 1967
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9985.4 residents per day on average

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0614071Folsom Convalescent Hospital510 Mill Street, Folsom, CA 95630Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Locations

510 Mill St
Folsom, CA 95630
Phone (916) 985-3641

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
Ninel C Elmont Individual 5% Or Greater Direct Ownership InterestDirector Oct 1, 2010 50%
Corporate DirectorDirector Oct 1, 2010
Adp of the SNF Oct 1, 2010
Christopher Hamer Individual Adp of the SNF Oct 1, 2019
Donald Gutman Individual Operational/Managerial Control Dec 10, 1980
Adp of the SNF Dec 10, 1980
Brett Monson Elmont Individual Corporate OfficerCfo Jan 1, 2013
Adp of the SNF Sep 1, 2002
DVNC Ventures LLC Organization, Folsom, CA LLC 5% Or Greater Mortgage Interest Oct 1, 2010 100%
Adp of the SNF May 15, 2026
Bluff Enterprises Corp Organization, Folsom, CA Corporation, For-profit Operational/Managerial Control Oct 1, 2010
Calvin Callaway Individual 5% Or Greater Direct Ownership InterestOwner/ President Oct 1, 2010 50%
Operational/Managerial Control Oct 1, 2010
Adp of the SNF Oct 1, 2010

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730764800000",
    "number": "1679505572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 MILL ST",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956302607",
            "telephone_number": "916-985-3641",
            "fax_number": "916-985-7231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 MILL ST",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956302607",
            "telephone_number": "916-985-3641",
            "fax_number": "916-985-7231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUFF ENTERPRISES CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A",
        "authorized_official_last_name": "CALLAWAY",
        "authorized_official_first_name": "CALVIN",
        "authorized_official_middle_name": "WADE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "916-985-3641"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "030000040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZR05173F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Folsom Care Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Folsom Convalescent Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Folsom Convalescent Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Folsom, CA

Sources for this page

Verify at the official NPI Registry.