NPIMap

Organization Active NPI

State of California - Department of Developmental Services

Doing business as Porterville Developmental Center

  • Intellectual Disabilities Intermediate Care Facility
  • Porterville, CA
National Provider Identifier
1982990206
Registry record updated Jun 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
170000837 Issued in CA
Legal business name
STATE OF CALIFORNIA - DEPARTMENT OF DEVELOPMENTAL SERVICES
Doing business as
Porterville Developmental Center
Practice address
26501 Avenue 140
Porterville, CA 93257-9109
Phone
(559) 782-2222
Fax
(559) 782-5630
NPI assigned
Jun 24, 2011
Last updated
Jun 24, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
STATE OF CALIFORNIA - DEPARTMENT OF DEVELOPMENTAL SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 24, 2011

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

Authorized official

Name
Ms. Patricia Flannery
Title
Deputy Director
Phone
(916) 654-2232

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 170000837 CA Primary

Addresses

Primary practice location

26501 Avenue 140
Porterville, CA 93257-9109

Mailing address

PO Box 944202
1600 9TH Street Room 205
Sacramento, CA 94244-2020
Phone (916) 654-2431

Other names 1

  • Porterville Developmental Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1982990206. Details of each certification follow.

  • CCN 05G014 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details
  • CCN 55G802 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 05G014

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
PORTERVILLE DEVELOPMENT CENTER - DP ICF/IID
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Mar 1, 1980
Last certification
Sep 19, 2019
Beds
512
Ownership / control type
State
Facility address
26501 Avenue 140
Porterville, CA 93257

Intermediate care facility for individuals with intellectual disabilities certification: CCN 55G802

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
PORTERVILLE DEVELOPMENTAL CENTER D/P ICF-DD STAR
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Jun 14, 2022
Last certification
May 4, 2022
Beds
10
Ownership / control type
State
Facility address
26501 Avenue 140
Porterville, CA 93257

National Provider Directory

National Provider Directory
Tax ID family
State of California - Department of Developmental Services4 organizations share this tax ID, including this one
Part of
State of California - Department of Developmental Services

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": "1308873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308873600000",
    "number": "1982990206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 944202",
            "address_2": "1600 9TH STREET ROOM 205",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "942442020",
            "telephone_number": "916-654-2431",
            "fax_number": "916-654-3186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26501 AVENUE 140",
            "city": "PORTERVILLE",
            "state": "CA",
            "postal_code": "932579109",
            "telephone_number": "559-782-2222",
            "fax_number": "559-782-5630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF CALIFORNIA - DEPARTMENT OF DEVELOPMENTAL SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STATE OF CALIFORNIA - DEPARTMENT OF DEVELOPMENTAL SERVICES",
        "enumeration_date": "2011-06-24",
        "last_updated": "2011-06-24",
        "status": "A",
        "authorized_official_last_name": "FLANNERY",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "DEPUTY DIRECTOR",
        "authorized_official_telephone_number": "916-654-2232",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "CA",
            "license": "170000837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Porterville Developmental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Porterville, CA

Sources for this page

Verify at the official NPI Registry.