CEDACAL, LLC. (NPI# 1346711504) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346711504 |
| Entity Type | Organization |
| Organization Name | CEDACAL, LLC. |
| Practice Address |
5663 Cedarglen Dr Azusa CA 91702-5007 |
| Practice Telephone | 6263736211 |
| Mailing Telephone | 6263736211 |
| Enumeration Date | 2018-12-16 |
| Last Update Date | 2018-12-16 |
| Authorized Official Name | ROWIE JUCAL (ADMINISTRATOR/RN) |
| Authorized Official Telephone | 6263736211 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310500000X | Intermediate Care Facility, Mental Illness | Nursing & Custodial Care Facilities |
| Street Address |
5663 CEDARGLEN DR |
| City | AZUSA |
| State | CA |
| Zip Code | 91702-5007 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407345341 | Rosaura Contreras | Nutritionist | 109 West 6th Street, Azusa, CA 91702 | 2018-05-07 |
| 1093224396 | Beatriz Leyva Torres | Nurse Practitioner | 237 S. Vernon Ave, Azusa, CA 91702 | 2017-09-29 |
| 1871949370 | Angela Marie Mckindley | Case Manager/Care Coordinator | 23701 East Fork Rd., Azusa, CA 91702 | 2016-05-13 |
| 1023489846 | Crystal Horton | Case Manager/Care Coordinator | 23701 E Fork Road, Azusa, CA 91702 | 2015-10-20 |
| 1528438272 | Seann Mckay | Case Manager/Care Coordinator | 23701 E Folk Rd, Azusa, CA 91702 | 2015-10-06 |
| 1437528833 | William Clabaugh | Case Manager/Care Coordinator | 830 S. Azusa Ave., 45, Azusa, CA 91702 | 2015-09-16 |
| 1467850693 | Juana Gaeta | Speech-Language Pathologist | 1016 E Ghent St, Azusa, CA 91702 | 2014-12-22 |
| 1649674508 | Colleen Anne Montz | Nurse Practitioner | 901 E. Alosta Ave., Student Health Center, Azusa, CA 91702 | 2014-10-21 |
| 1285061390 | Patrick Ryan Bergeron | Physical Therapist | 900 W Sierra Madre Avenue, #33, Azusa, CA 91702 | 2013-10-03 |
| 1760768972 | Ashley L Wickliffe | Student in an Organized Health Care Education/Training Program | 901 East Alosta Avenue, Azusa, CA 91702 | 2011-11-01 |
| Find all providers in zip 91702 | ||||
| Taxonomy Code | 310500000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mental Illness |
| A nursing facility that provides an intermediate level of nursing care to individuals whose functional abilities are significantly compromise by mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487282273 | Crestwood Behavioral Health, Inc. | Intermediate Care Facility, Mental Illness | 303 S C St, Lompoc, CA 93436-7305 | 2020-03-29 |
| 1497386569 | M&s Guesthomes, Inc. | Intermediate Care Facility, Mental Illness | 2424 W Glencrest Ave, Anaheim, CA 92801-3224 | 2020-01-28 |
| 1396213302 | Amazing Grace Oasis II | Intermediate Care Facility, Mental Illness | 8708 Bridgeport Ave, Hesperia, CA 92344-5562 | 2018-11-07 |
| 1972081651 | Oc Care Centers, Inc. | Intermediate Care Facility, Mental Illness | 127 N Queensbury St, Anaheim, CA 92806-3814 | 2018-08-03 |
| 1659858868 | Athina Kamar | Intermediate Care Facility, Mental Illness | 5826 Jumilla Ave, Woodland Hills, CA 91367-5604 | 2018-07-20 |
| 1447758024 | Crestwood Behavioral Health Inc | Intermediate Care Facility, Mental Illness | 450 Stanyan St Fl 5, San Francisco, CA 94117-1019 | 2018-01-29 |
| 1376067439 | Alacar. Inc | Intermediate Care Facility, Mental Illness | 4640 E Kaviland Ave, Fresno, CA 93725-1632 | 2017-07-31 |
| 1912358904 | American Helath Services | Intermediate Care Facility, Mental Illness | 1524 W 227th St Apt 1, Torrance, CA 90501-4917 | 2016-06-30 |
| 1639547896 | Arcaida Home Care & Staffing | Intermediate Care Facility, Mental Illness | 1090 E Cypress Ave, Suite B, Redding, CA 96002-1163 | 2015-09-04 |
| 1023495181 | Crestwood Behavioral Health, Inc. | Intermediate Care Facility, Mental Illness | 960 Third Ave, Chula Vista, CA 91911 | 2015-04-28 |
| Find all providers with the same taxonomy | ||||
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| 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.