NPIMap

Organization Active NPI

Community Seniorserv, Inc.

Doing business as Santa Ana Vip Adult Day Health Care

  • Health Service Clinic/Center
  • Santa Ana, CA
National Provider Identifier
1710104344
Registry record updated Feb 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
060000064 Issued in CA
Legal business name
COMMUNITY SENIORSERV, INC.
Doing business as
Santa Ana Vip Adult Day Health Care
Practice address
1101 S Grand Ave
Santa Ana, CA 92705-4100
Phone
(714) 558-1216
Fax
(714) 564-0386
NPI assigned
Apr 18, 2007
Last updated
Feb 24, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2015

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

Authorized official

Name
Holly Hagler
Title
Executive Director
Phone
(714) 220-0224

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X 060000064 CA Primary

Addresses

Primary practice location

1101 S Grand Ave
Santa Ana, CA 92705-4100

Mailing address

1200 N Knollwood Cir
Anaheim, CA 92801-1309
Phone (714) 220-0224

Other identifiers 2

IdentifierTypeStateIssuer
013679OtherCASCAN PROVIDER ID
ADU70080FMedicaidCA

Other names 1

  • SANTA ANA VIP ADULT DAY HEALTH CARE Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Community Seniorserv Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

1101 S Grand Ave
Santa Ana, CA 92705
Phone (714) 558-1216

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424736000000",
    "number": "1710104344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N KNOLLWOOD CIR",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928011309",
            "telephone_number": "714-220-0224",
            "fax_number": "714-816-7397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 S GRAND AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927054100",
            "telephone_number": "714-558-1216",
            "fax_number": "714-564-0386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY SENIORSERV, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-18",
        "last_updated": "2015-02-24",
        "status": "A",
        "authorized_official_last_name": "HAGLER",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "714-220-0224"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "CA",
            "license": "060000064",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SCAN PROVIDER ID",
            "identifier": "013679",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ADU70080F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SANTA ANA VIP ADULT DAY HEALTH CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2015; 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.