NPIMap

Organization Active NPI

JWCH Institute, Inc

  • Federally Qualified Health Center (FQHC)
  • Lynwood, CA
National Provider Identifier
1750832515
Registry record updated Jan 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
JWCH INSTITUTE, INC
Practice address
12124 Bullis Rd Ste B104
Lynwood, CA 90262-5106
Phone
(323) 201-4516
Fax
(323) 215-0170
NPI assigned
Oct 17, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2023

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

Authorized official

Name
Alvaro P. Ballesteros
Title
Chief Executive Officer
Phone
(323) 201-4516

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Home Health Agency 251E00000X
Community Health Clinic/Center 261QC1500X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

12124 Bullis Rd Ste B104
Lynwood, CA 90262-5106

Mailing address

5650 Jillson Street
Commerce, CA 90040-1482
Phone (323) 201-4516

Other names 2

  • Wesley Health Centers (Lynwood Middle School) Doing business as
  • Wesley Health Centers - Lynwood High School Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191216001116 CA Part A Provider - Federally Qualified Health Center (FQHC) 1850394123 Practice locations: Lynwood, CA

Federally qualified health center certification: CCN A01081

Legal name
JWCH INSTITUTE INC
Doing business as
WESLEY HEALTH CENTERS - LYNWOOD MIDDLE SCHOOL
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 11, 2019
Last certification
Dec 11, 2019
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Oct 4, 1960 in CA
Enrollment address
12124 Bullis Rd
Lynwood, CA 90262-5106

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
05D2153183Wesley Health Centers (Lynwood High School)12124 Bullis Road Ste B104, Lynwood, CA 90262Certificate of waiverAug 22, 2026

National Provider Directory

National Provider Directory
Tax ID family
Wesley Health Centers - Michael Antonovich Dental Clinic68 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

12124 Bullis Rd
Ste B104
Lynwood, CA 90262

Ownership & related parties

All disclosed owners & managing parties 14

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Thomas Grode Individual Corporate DirectorBoard Member Jan 26, 2016
Joseph Castel Individual Corporate DirectorBoard Member Jul 13, 2004
Andy Irie Individual Corporate OfficerChief Administrative Officer Jan 1, 2010
Paul Gerald Gregerson Individual Corporate OfficerChief Medical Officer Jan 1, 2001
Jeanne Lam Individual Corporate OfficerChief Financial Officer Jul 1, 2005
Eduardo Saucedo Individual Corporate DirectorBoard Member Jul 26, 2016
Alvaro P Ballesteros Individual Corporate OfficerChief Executive Officer Oct 1, 2003
Herbert Torrence Individual Corporate DirectorBoard Member Feb 28, 2017
Kathleen House Individual Corporate DirectorBoard Member - Secretary Nov 22, 2011
Silvia Hernandez Individual Corporate DirectorBoard Member Sep 23, 2014
Marie McAfee Individual Operational/Managerial Control Nov 1, 2012
Lawrence Fernandez Individual Corporate DirectorBoard Member Jun 25, 2002
Maria a Padron Individual Corporate DirectorBoard Member Feb 14, 2007
Sheila Eaton Individual Corporate DirectorBoard Member Sep 24, 2013

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
JWCH Medical Clinic @ Bell ShelterBell, CA, CCN 751883 Federally qualified health center Operational/Managerial Control (100%) Jan 1, 2015
Wesley Health Centers - Palmdale CentralPalmdale, CA, CCN 921169 Federally qualified health center Operational/Managerial Control (100%) Apr 15, 2019

NPI Registry JSON

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

{
    "created_epoch": "1476662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672963200000",
    "number": "1750832515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5650 JILLSON STREET",
            "city": "COMMERCE",
            "state": "CA",
            "postal_code": "900401482",
            "telephone_number": "323-201-4516",
            "fax_number": "323-215-0170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12124 BULLIS RD STE B104",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902625106",
            "telephone_number": "323-201-4516",
            "fax_number": "323-215-0170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JWCH INSTITUTE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-17",
        "last_updated": "2023-01-06",
        "certification_date": "2023-01-06",
        "status": "A",
        "authorized_official_last_name": "BALLESTEROS",
        "authorized_official_first_name": "ALVARO",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "323-201-4516"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wesley Health Centers (Lynwood Middle School)",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Wesley Health Centers - Lynwood High School",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lynwood, CA

Sources for this page

Verify at the official NPI Registry.