Gabriel Care Home Inc

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

License

LTC80353F Issued in CA

Legal business name

GABRIEL CARE HOME INC

Doing business as

Bearcreekicf

Practice address

4617 E Bearcreek Road
Lodi, CA 95240

Phone

(209) 369-5973

Fax

(209) 369-5698

NPI assigned

May 5, 2008

Last updated

May 5, 2008By the provider in NPPES

Organization subpart

Yes

Parent organization

GABRIEL CARE HOME INCAs reported in NPPES

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

Authorized official

Name

Mrs. Elena Paiste Gabriel, RN

Title

RN Administrator

Phone

(209) 598-1436

Specialties & licenses 1

Addresses

Other names 1

• BEARCREEKICF Doing business as

Part of

Gabriel Care Home Inc

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

{
    "created_epoch": "1209945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209945600000",
    "number": "1679749139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2216 ALPINE DR",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952406703",
            "telephone_number": "209-333-0592",
            "fax_number": "209-368-2771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4617 E BEARCREEK ROAD",
            "city": "LODI",
            "state": "CA",
            "postal_code": "95240",
            "telephone_number": "209-369-5973",
            "fax_number": "209-369-5698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GABRIEL CARE HOME INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GABRIEL CARE HOME INC",
        "enumeration_date": "2008-05-05",
        "last_updated": "2008-05-05",
        "status": "A",
        "authorized_official_last_name": "GABRIEL",
        "authorized_official_first_name": "ELENA",
        "authorized_official_middle_name": "PAISTE",
        "authorized_official_title_or_position": "RN ADMINISTRATOR",
        "authorized_official_telephone_number": "209-598-1436",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "CA",
            "license": "LTC80353F",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BEARCREEKICF",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Katie Frink
• Roger Fuentes
• Funto Ayanleke DDS
• Courtney Furst, PA-C
• Lacey Gabales
• Amanda Marie Gaitaud, L.AC
• Randolph Beltran Galang, O.D.
• Galen Inpatient Physicians PC
• John Galvez
• Arlett Guadalupe Gamez

• Intellectual Disabilities Intermediate Care Facility in Lodi, CA
• Providers in Lodi, CA by specialty
• Intellectual Disabilities Intermediate Care Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2008; 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.