Cobble Stone Residential Home Care LLC.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

COBBLE STONE RESIDENTIAL HOME CARE LLC.

Practice address

9320 Cobble Mountain Rd
Bakersfield, CA 93313-5373

Phone

(661) 397-0885

Fax

(661) 855-4409

NPI assigned

Sep 11, 2020

Organization subpart

No

Name

Mrs. Catherine T. C Lark, ADMINISTRATORNPI 1548826860

Title

Administrator

Phone

(661) 397-0885

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Catherine Tagulao Clark

  • In Home Supportive Care Agency
  • Bakersfield, CA
  • NPI 1548826860

  Assisted Living Facility

  NPD Authorized official

• Cobble Stone Residential Home Care LLC. Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 11, 2020.

{
    "created_epoch": "1599782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599782400000",
    "number": "1861007270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9320 COBBLE MOUNTAIN RD",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933135373",
            "telephone_number": "661-397-0885",
            "fax_number": "661-855-4409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9320 COBBLE MOUNTAIN RD",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933135373",
            "telephone_number": "661-397-0885",
            "fax_number": "661-855-4409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COBBLE STONE RESIDENTIAL HOME CARE LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-11",
        "last_updated": "2020-09-11",
        "certification_date": "2020-09-11",
        "status": "A",
        "authorized_official_last_name": "C LARK",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "661-397-0885",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "ADMINISTRATOR"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1548826860",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Bakersfield",
            "affiliation": "N",
            "endpointDescription": "Bakersfield",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Bakersfield",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Bakersfield",
            "address_1": "9320 Cobble Mountain Rd",
            "city": "Bakersfield",
            "state": "CA",
            "country_code": "US",
            "postal_code": "933135373",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Cobble Stone Residential Home Care LLC.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Bakersfield, CA
• Assisted Living Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.