LANDMARK MEDICAL CENTER


Address: 2030 N Garey Ave, Pomona, CA 91767-2722
Phone: 9095932585

LANDMARK MEDICAL CENTER (NPI# 1073722005) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1073722005
Entity Type Organization
Organization Name LANDMARK MEDICAL CENTER
Other Organization Name LANDMARK MEDICAL CENTER
Practice Address 2030 N Garey Ave
Pomona
CA 91767-2722
Practice Telephone 9095932585
Practice Fax Number 9095934120
Mailing Telephone 9095932585
Mailing Fax Number 9095934120
Enumeration Date 2007-05-22
Last Update Date 2011-08-26
Authorized Official Name ROSEMARY CAMPOS KILBY (ADMINISTRATOR)
Authorized Official Telephone 9095932585
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 323P00000X Psychiatric Residential Treatment Facility 950000062 CA Residential Treatment Facilities
Y 323P00000X Psychiatric Residential Treatment Facility Residential Treatment Facilities

Other Provider/Organization Names

Other Name Type Code
Landmark Medical Center Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1942412002 Landmark Medical Center Clinical Neuropsychologist 115 Cass Ave, Woonsocket, RI 02895-4705 2007-05-03
1043297112 Landmark Medical Center Internal Medicine 115 Cass Ave, Woonsocket, RI 02895-4705 2005-12-29
1982681060 Landmark Medical Center Nuclear Medicine 115 Cass Ave, Woonsocket, RI 02895-4705 2005-12-29
1619954724 Landmark Medical Center Preventive Medicine 115 Cass Ave, Woonsocket, RI 02895-4705 2005-12-29
1285611392 Landmark Medical Center Nurse Practitioner 115 Cass Ave, Woonsocket, RI 02895-4705 2005-12-29
1629055751 Landmark Medical Center Pathology 115 Cass Ave, Woonsocket, RI 02895-4705 2005-12-29

Other Data Sources

Entity Type Entity Name Entity Address
System for Award Management (SAM) Entities LANDMARK MEDICAL CENTER 115 Cass Ave, Woonsocket, RI 02895-4705

Office Location

Street Address 2030 N GAREY AVE
City POMONA
State CA
Zip Code 91767-2722

Providers in the same location

NPI Name Taxonomy Address Enumeration
1790811610 Samuel W Kaufman Psychiatry & Neurology 2030 N Garey Ave, Pomona, CA 91767-2722 2007-02-26
1790267292 Jennifer A Nevitt Psychologist 2030 N Garey Ave, Pomona, CA 91767-2722 2018-08-30

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Taxonomy Information

Taxonomy Code 323P00000X
Grouping Residential Treatment Facilities
Classification Psychiatric Residential Treatment Facility

Taxonomy Definition

A residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four hour, therapeutically planned group living and learning situation where distinct and individualized psychotherapeutic interventions can take place. Residential treatment is a specific level of care to be differentiated from acute, intermediate, and long-term hospital care, when the least restrictive environment is maintained to allow for normalization of the patient’s surroundings. The RTF must be both physically and programmatically distinct if it is a part or subunit of a larger treatment program. An RTF is organized and professionally staffed to provide residential treatment of mental disorders to children and adolescents who have sufficient intellectual potential to respond to active treatment (that is, for whom it can reasonably be assumed that treatment of the mental disorder will result in an improved ability to function outside the RTF) for whom outpatient treatment, partial hospitalization or protected and structured environment is medically or psychologically necessary
Notes: Source: Champus Policy manual, Volume II, p. 6010.47M dated 9/12/94. Revision: Definition title revised 7/1/03

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Competitor

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City POMONA
Zip Code 91767

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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