United Care Providers-St Mary'S
Organization Active NPI Intellectual Disabilities Intermediate Care Facility · Valinda, CA
NPI 1952372997 · NPPES record last updated Jun 30, 2009
Key facts
- NPI
- 1952372997
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Intellectual Disabilities Intermediate Care Facility 315P00000X
- License
- 960000848 (CA)
- Legal business name
- UNITED CARE PROVIDERS-ST MARY'S
- Practice address
- 16765 Lawnwood St
Valinda, CA 91744-3319 - Phone
- (562) 698-7286
- Fax
- (562) 945-6388
- NPI assigned
- Jan 28, 2006
- Organization subpart
- No
Authorized official
- Name
- Adolfo J Festejo
- Title
- VP/Cfo
- Phone
- (818) 802-6363
Corporate family (same tax ID) 3
National Provider Directory
- Tax ID family
- United Care Providers-Holy Infant
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual Disabilities Intermediate Care Facility | 315P00000X | 960000848 | CA | Yes |
Addresses
Primary practice location
16765 Lawnwood St
Valinda, CA 91744-3319
Mailing address
18409 Dancy St
Rowland Heights, CA 91748-4755
Phone (818) 802-6303
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LTC80098F | Medicaid | CA |
Other providers in Valinda, CA
All providers in Valinda, CA · Intellectual Disabilities Intermediate Care Facility in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 30, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.