Organization Active NPI

Belle Icf

  • Intellectual Disabilities Intermediate Care Facility
  • Antioch, CA
National Provider Identifier
1679770499
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
BELLE ICF
Practice address
1747 Sanger Peak Way
Antioch, CA 94531-9128
Phone
(925) 383-4512
Fax
(925) 778-6413
NPI assigned
Jun 27, 2007
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
Dominador Delacruz Pajarito, B.A., M.A.
Title
Licensee
Phone
(925) 383-4512

Specialties & licenses 1

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

Addresses

Primary practice location

1747 Sanger Peak Way
Antioch, CA 94531-9128

Mailing address

1747 Sanger Peak Way
Antioch, CA 94531-9128
Phone (925) 383-4512

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1679770499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1747 SANGER PEAK WAY",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945319128",
            "telephone_number": "925-383-4512",
            "fax_number": "925-778-6413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1747 SANGER PEAK WAY",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945319128",
            "telephone_number": "925-383-4512",
            "fax_number": "925-778-6413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLE ICF",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PAJARITO",
        "authorized_official_first_name": "DOMINADOR",
        "authorized_official_middle_name": "DELACRUZ",
        "authorized_official_title_or_position": "LICENSEE",
        "authorized_official_telephone_number": "925-383-4512",
        "authorized_official_credential": "B.A., M.A."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Antioch, 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.