NPIMap

Organization Active NPI

Slow Sculpture

  • Nursing Facility/Intermediate Care Facility
  • Santa Rosa, CA
National Provider Identifier
1831263078
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
Legal business name
SLOW SCULPTURE
Practice address
5715 Monte Verde Dr
Santa Rosa, CA 95409-3921
Phone
(707) 537-7024
Fax
(707) 537-1753
NPI assigned
Nov 20, 2006
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
Mrs. Sarane Alison Baker-Colli NS
Title
Cfo
Phone
(707) 537-7024

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X CA Primary

Addresses

Primary practice location

5715 Monte Verde Dr
Santa Rosa, CA 95409-3921

Mailing address

5715 Monte Verde Dr
Santa Rosa, CA 95409-3921
Phone (707) 537-7024

Other names 1

  • MONTE VERDE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Intermediate care facility for individuals with intellectual disabilities certification: CCN 55G355

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
MONTE VERDE
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Nov 28, 2000
Last certification
Jul 25, 2024
Beds
6
Ownership / control type
Private (proprietary)
Facility address
5715 Monte Verde Drive
Santa Rosa, CA 95409

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
05D0985408Slow Sculpture5715 Monte Verde, Santa Rosa, CA 95409Certificate of waiverApr 16, 2027

National Provider Directory

National Provider Directory
Tax ID family
Badger Creek3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1831263078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5715 MONTE VERDE DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954093921",
            "telephone_number": "707-537-7024",
            "fax_number": "707-537-1753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5715 MONTE VERDE DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954093921",
            "telephone_number": "707-537-7024",
            "fax_number": "707-537-1753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SLOW SCULPTURE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BAKER-COLLI NS",
        "authorized_official_first_name": "SARANE",
        "authorized_official_middle_name": "ALISON",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "707-537-7024",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MONTE VERDE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.