Active NPI
S.C.C.H., Inc.
Doing business as Courtyard Care Center
- Skilled Nursing Facility
- Signal Hill, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 940000159
- Legal business name
- S.C.C.H., INC.
- Doing business as
- Courtyard Care Center
- Practice address
- 1880 Dawson Ave
Signal Hill, CA 90806-5913 - Phone
- (562) 494-5188
- NPI assigned
- Dec 7, 2005
- Last updated
- Apr 5, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Marc Johnson
- Title
- Chief Financial Officer
- Phone
- (949) 373-8373
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 940000159 | CA | Primary |
Addresses
Primary practice location
1880 Dawson Ave
Signal Hill, CA 90806-5913
Mailing address
1880 Dawson Ave
Signal Hill, CA 90755-5913
Phone (562) 494-5188
Other names 1
- COURTYARD CARE CENTER
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170127001403 | CA | Part A Provider - Skilled Nursing Facility | 0648399725 | Practice locations: Signal Hill, CA |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1942285440. Details of each certification follow.
Skilled nursing facility certification: CCN 555785
- Legal name
- S.C.C.H., INC.
- Doing business as
- COURTYARD CARE CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jun 5, 1997
- Last certification
- Oct 18, 2024
- Beds
- 59
- Ownership / control type
- Corporation
- Organization structure
- Corporation
- Incorporated
- May 28, 1993 in NV
- Enrollment address
- 1880 Dawson Ave
Signal Hill, CA 90755-5913 - Nursing home name
- COURTYARD CARE CENTER
- Affiliated entity
- NAHS
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Courtyard Care Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Jun 5, 1997
- Medicare certification status
- Active
- Certified beds
- 59
- Chain
- Nahs
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D0875354 | Courtyard Care Center | Certificate of waiver | Aug 19, 2027 |
National Provider Directory
National Provider DirectoryLocations
1880 Dawson Ave
Signal Hill, CA 90755
Phone (562) 494-5188
Ownership & related parties
All disclosed owners & managing parties 13
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Mark Walton | Corporate Officer | Jun 29, 2018 | |
| Corporate Director | Jun 29, 2018 | ||
| James Barlow | Corporate Director | Jun 29, 2018 | |
| Timothy J Paulsen | Corporate Director | Jun 29, 2018 | |
| Michael J Moore | Corporate Officer | Feb 1, 2022 | |
| Corporate Director | Feb 1, 2022 | ||
| Brenden Q Dahl | Corporate Director | Feb 20, 2026 | |
| Managing Control - Governing Body | Feb 20, 2026 | ||
| Vannarith So | Operational/Managerial Control | Oct 1, 2012 | |
| Adp of the SNF | Oct 1, 2012 | ||
| Fernan Tolentino | Corporate Officer | Mar 13, 2025 | 100% |
| Corporate Director | Mar 13, 2025 | 100% | |
| Operational/Managerial Control | Mar 13, 2025 | ||
| Managing Control - Governing Body | Mar 13, 2025 | ||
| Adp of the SNF | Mar 13, 2025 | ||
| Victor G Lundquist | Corporate Officer | Mar 21, 2018 | |
| Nahs Southwest Inc | 5% Or Greater Direct Ownership Interest | Jun 30, 2018 | 100% |
| Indirect Ownership Interest | Jun 30, 2018 | 100% | |
| Marc Johnson | Corporate Officer | Nov 20, 2022 | |
| Adp of the SNF | Nov 20, 2022 | ||
| Indirect Ownership Interest | Jun 30, 2018 | 100% | |
| Ralph Baja | Corporate Director | Jul 1, 2023 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Internal Medicine Physician
- Long Beach, CA
- NPI 1659416584
Adp of the SNF, Operational/Managerial Control
Facilities with the same owner 2
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba Brentwood Health Care Center
- Skilled Nursing Facility
- Santa Monica, CA
- NPI 1962487272
Nahs Southwest Inc
-
dba Fireside Convalescent Hospital
- Skilled Nursing Facility
- Santa Monica, CA
- NPI 1679558175
Nahs Southwest Inc
Practitioners & affiliated clinicians
Affiliated clinicians 5
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Geriatric Medicine (Internal Medicine) Physician
- Downey, CA
- NPI 1679682876
Nursing home
-
- Geriatric Medicine (Family Medicine) Physician
- Long Beach, CA
- NPI 1982627956
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133913600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1712275200000",
"number": "1942285440",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1880 DAWSON AVE",
"city": "SIGNAL HILL",
"state": "CA",
"postal_code": "907555913",
"telephone_number": "562-494-5188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1880 DAWSON AVE",
"city": "SIGNAL HILL",
"state": "CA",
"postal_code": "908065913",
"telephone_number": "562-494-5188"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "S.C.C.H., INC.",
"organizational_subpart": "NO",
"enumeration_date": "2005-12-07",
"last_updated": "2024-04-05",
"certification_date": "2024-04-05",
"status": "A",
"authorized_official_last_name": "JOHNSON",
"authorized_official_first_name": "MARC",
"authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
"authorized_official_telephone_number": "949-373-8373"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "CA",
"license": "940000159",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "COURTYARD CARE CENTER",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "COURTYARD CARE CENTER",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Signal Hill, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.