NPIMap

Organization Active NPI

C.R.E. Enterprise. Inc,

  • Intellectual Disabilities Intermediate Care Facility
  • South San Francisco, CA
National Provider Identifier
1891822219
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
C.R.E. ENTERPRISE. INC,
Practice address
138 Rosewood Way
South San Francisco, CA 94080-5846
Phone
(650) 340-0025
Fax
(650) 340-0414
NPI assigned
Feb 27, 2007
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. Evelyn Balatbat Ryan
Title
Provider
Phone
(650) 340-0025

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X CA Primary

Addresses

Primary practice location

138 Rosewood Way
South San Francisco, CA 94080-5846

Mailing address

138 Rosewood Way
South San Francisco, CA 94080-5846
Phone (650) 340-0025

Other identifiers 1

IdentifierTypeStateIssuer
LTC61016FOtherCAPROVIDER #

Other names 1

  • Rosewood Home Other name

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 55G467

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
ROSEWOOD HOME ICF/DDH
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Jun 11, 2003
Last certification
Jan 16, 2025
Beds
6
Ownership / control type
Private (proprietary)
Facility address
138 Rosewood Way
South San Francisco, CA 94080

National Provider Directory

National Provider Directory
Tax ID family
Cre Enterprise Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1891822219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 ROSEWOOD WAY",
            "city": "SOUTH SAN FRANCISCO",
            "state": "CA",
            "postal_code": "940805846",
            "telephone_number": "650-340-0025",
            "fax_number": "650-340-0414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 ROSEWOOD WAY",
            "city": "SOUTH SAN FRANCISCO",
            "state": "CA",
            "postal_code": "940805846",
            "telephone_number": "650-340-0025",
            "fax_number": "650-340-0414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C.R.E. ENTERPRISE. INC,",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RYAN",
        "authorized_official_first_name": "EVELYN",
        "authorized_official_middle_name": "BALATBAT",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "650-340-0025",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER #",
            "identifier": "LTC61016F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rosewood Home",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in South San Francisco, CA

Sources for this page

Verify at the official NPI Registry.