COVENANT CARE CALIFORNIA, LLC (NPI# 1437291929) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437291929 |
| Entity Type | Organization |
| Organization Name | COVENANT CARE CALIFORNIA, LLC |
| Other Organization Name | VINTAGE FAIRE NURSING & REHABILITATION CENTER |
| Practice Address |
3620 Dale Rd Suite B Modesto CA 95356-0598 |
| Practice Telephone | 2095212094 |
| Practice Fax Number | 2095216180 |
| Mailing Telephone | 2095212094 |
| Mailing Fax Number | 2095216180 |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2014-02-03 |
| Authorized Official Name | CAROL SPARKS (DIRECTOR OF REIMBURSEMENT) |
| Authorized Official Telephone | 9493491200 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 100000366 | CA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | LTC55355H | 05 | |
| CA | OSHPD | 206504004 | 01 |
| Other Name | Type Code |
|---|---|
| Vintage Faire Nursing & Rehabilitation Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780719278 | Covenant Care California, LLC | Skilled Nursing Facility | 911 Bryant Street, Palo Alto, CA 94301-2711 | 2007-02-23 |
| 1043345812 | Covenant Care California, LLC | Skilled Nursing Facility | 809 Fremont Avenue, Los Altos, CA 94024-5617 | 2007-02-22 |
| 1346382298 | Covenant Care California, LLC | Skilled Nursing Facility | 2124 57th Avenue, Oakland, CA 94621-4322 | 2007-02-13 |
| 1134261142 | Covenant Care California, LLC | Skilled Nursing Facility | 6821 24th Street, Sacramento, CA 95822-4037 | 2007-02-13 |
| 1831231877 | Covenant Care California, LLC | Skilled Nursing Facility | 8170 Murray Avenue, Gilroy, CA 95020-4605 | 2007-02-13 |
| 1053453902 | Covenant Care California, LLC | Skilled Nursing Facility | 2725 Pacific Avenue, Long Beach, CA 90806-2612 | 2007-02-13 |
| 1528100013 | Covenant Care California, LLC | Skilled Nursing Facility | 577 South Peach Avenue, Fresno, CA 93727-3952 | 2007-02-13 |
| 1801938816 | Covenant Care California, LLC | Skilled Nursing Facility | 9289 Branstetter Place, Stockton, CA 95209-1700 | 2007-02-13 |
| 1164563276 | Covenant Care California, LLC | Skilled Nursing Facility | 1111 E. Tuolumne Road, Turlock, CA 95382-1541 | 2007-02-09 |
| 1205977311 | Covenant Care California, LLC | Skilled Nursing Facility | 160 S Patterson Avenue, Santa Barbara, CA 93111-2006 | 2007-02-09 |
| Street Address |
3620 DALE RD SUITE B |
| City | MODESTO |
| State | CA |
| Zip Code | 95356-0598 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902376502 | Katherine Avila | Physical Therapist | 3620 Dale Rd, Modesto, CA 95356-0598 | 2018-11-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649809021 | Amelia E Delgadillo | Licensed Vocational Nurse | 501 Triangle Rd, Modesto, CA 95356 | 2020-04-07 |
| 1689220279 | Meagan Veneman | Physical Medicine & Rehabilitation | 125 Hogue Rd, Modesto, CA 95356 | 2019-08-10 |
| 1497131213 | Hermes Guardian Transport | Non-emergency Medical Transport (VAN) | 4221 Erin Way, Modesto, CA 95356 | 2015-08-04 |
| 1811373640 | Melissa Ruiz | Marriage & Family Therapist | 5815 Stoddard Rd Suite 600, Modesto, CA 95356 | 2015-08-04 |
| 1922242866 | Lifecare Solutions Inc | Durable Medical Equipment & Medical Supplies | 500 Glass Ln Ste H, Modesto, CA 95356 | 2009-04-22 |
| 1659541647 | Ashley Allison Streeter | Dentist | 556 Lyell Dr, Modesto, CA 95356 | 2008-03-05 |
| 1265636013 | Margaret Kathleen Grisell | Orthopaedic Surgery | 4601 Dale Ave, Kaiser Modesto Medical Center, Orthopedic Surgery, Modesto, CA 95356 | 2007-06-14 |
| 1841412111 | Bobby Gene Boswell | Specialist/Technologist | 3908 Vintage Cove, Modesto, CA 95356 | 2007-05-03 |
| 1598892861 | Merritt Radiological Medical Group Inc | Radiology | 526 Charity Way, Modesto, CA 95356 | 2007-02-27 |
| 1396871091 | Michael Steven Beck | Social Worker | 4640 Spyres Way, Building B, Suite 7, Modesto, CA 95356 | 2007-02-26 |
| Find all providers in zip 95356 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932251808 | Cf Modesto, LLC | Skilled Nursing Facility | 159 East Orangeburg Avenue, Modesto, CA 95350 | 2007-01-18 |
| 1427110055 | Sky Park Health Care Inc. | Skilled Nursing Facility | 1611 Scenic Dr, Modesto, CA 95355-4907 | 2006-12-13 |
| 1033221999 | Yosemite Convalescent Hospital, Inc. | Skilled Nursing Facility | 159 E Orangeburg Ave, Modesto, CA 95350-5334 | 2006-08-31 |
| 1508884487 | Crestwood Behavioral Health, Inc. | Skilled Nursing Facility | 1400 Celeste Dr, Modesto, CA 95355-5041 | 2006-07-18 |
| 1801832464 | Fig Holdings, LLC | Skilled Nursing Facility | 1310 W Granger Ave, Modesto, CA 95350-3911 | 2006-06-21 |
| 1487641361 | Covenant Care California Inc | Skilled Nursing Facility | 3620b Dale Rd, Modesto, CA 95356-0500 | 2005-10-05 |
| 1851385843 | Avalon Care Center - Modesto Hylond, LLC | Skilled Nursing Facility | 1900 Coffee Rd, Modesto, CA 95355-2703 | 2005-09-06 |
| 1245237965 | Evergreen Convalescent Hospital and Rehabilitation Center, Inc. | Skilled Nursing Facility | 2030 Evergreen Ave, Modesto, CA 95350-3785 | 2005-07-07 |
| 1154325512 | Ghc of Modesto, LLC | Skilled Nursing Facility | 2633 W Rumble Rd, Modesto, CA 95350-0154 | 2005-06-13 |
| 1255938015 | Newport LLC. | Skilled Nursing Facility | 2030 Evergreen Ave, Modesto, CA 95350-3785 | 2020-10-05 |
| Find all providers in MODESTO | ||||
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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.