Organization Active NPI

Garden Crest Convalescent Hospital Inc

  • Skilled Nursing Facility
  • Los Angeles, CA
National Provider Identifier
1861480097
Registry record updated Dec 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
970000031 Issued in CA
Legal business name
GARDEN CREST CONVALESCENT HOSPITAL INC
Practice address
909 Lucile Ave
Los Angeles, CA 90026-1511
Phone
(323) 663-8281
Fax
(323) 666-0095
NPI assigned
Oct 11, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2009

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

Authorized official

Name
Mr. Paul H Barron
Title
Administrator
Phone
(323) 663-8281

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 970000031 CA Primary

Addresses

Primary practice location

909 Lucile Ave
Los Angeles, CA 90026-1511

Mailing address

909 Lucile Ave
Los Angeles, CA 90026-1511
Phone (323) 663-8281

Other identifiers 2

IdentifierTypeStateIssuer
LTC05161FMedicaidCA
0691270001OtherCACIGNA-DMERC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100112000101 CA Part A Provider - Skilled Nursing Facility 2466593520 Practice locations: Los Angeles, CA

Skilled nursing facility certification: CCN 055161

Legal name
GARDEN CREST CONVALESCENT HOSPITAL INC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 1, 1979
Last certification
Nov 15, 2024
Beds
72
Ownership / control type
Corporation
Organization structure
CorporationProprietary
Incorporated
Jan 1, 1978 in CA
Enrollment address
909 Lucile Ave
Los Angeles, CA 90026-1511
Nursing home name
GARDEN CREST REHABILITATION CENTER

Care Compare: Nursing home

Medicare Care Compare
Listed as
Garden Crest Rehabilitation CenterCCN 055161 · All quality measures
Overall star rating
2 of 5
Health inspections
3 of 5
Staffing
1 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jan 1, 1979
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
7260.0 residents per day on average

Processed by Care Compare on Aug 1, 2026.

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
05D0899603Garden Crest Convalescent Hospital909 North Lucile Avenue, Los Angeles, CA 90026Certificate of waiverApr 2, 2027

National Provider Directory

National Provider Directory

Locations

909 Lucile Ave
Los Angeles, CA 90026
Phone (323) 663-8281

Ownership & related parties

All disclosed owners & managing parties 1

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

NameRoleSinceShare
Paul Barron Individual 5% Or Greater Direct Ownership InterestCeo,Board Member,Adm,Dir,Mang Emplo May 30, 1980 100%
Corporate DirectorCeo,Board Member,Adm,Dir,Mang Emplo May 30, 1980 100%
W-2 Managing EmployeeCeo,Board Member,Adm,Dir,Mang Emplo May 30, 1980 100%

Practitioners & affiliated clinicians

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262044800000",
    "number": "1861480097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 LUCILE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900261511",
            "telephone_number": "323-663-8281",
            "fax_number": "323-666-0095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 LUCILE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900261511",
            "telephone_number": "323-663-8281",
            "fax_number": "323-666-0095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARDEN CREST CONVALESCENT HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-11",
        "last_updated": "2009-12-29",
        "status": "A",
        "authorized_official_last_name": "BARRON",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "323-663-8281",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "970000031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC05161F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA-DMERC",
            "identifier": "0691270001",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.