AG LA MESA, LLC (NPI# 1457345001) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457345001 |
| Entity Type | Organization |
| Organization Name | AG LA MESA, LLC |
| Other Organization Name | COUNTRY MANOR LA MESA HEALTHCARE CENTER |
| Practice Address |
5696 Lake Murray Boulevard La Mesa CA 91942 |
| Practice Telephone | 6194607871 |
| Practice Fax Number | 6194604810 |
| Mailing Telephone | 6194607871 |
| Mailing Fax Number | 3105741322 |
| Enumeration Date | 2005-09-08 |
| Last Update Date | 2014-07-21 |
| Authorized Official Name | MR. JACOB WINTNER (MANAGER) |
| Authorized Official Telephone | 3236511808 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 080000020 | CA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | ZZT05910J | 05 |
| Other Name | Type Code |
|---|---|
| Country Manor La Mesa Healthcare Center | Doing Business As Name - Organization |
| Street Address |
5696 LAKE MURRAY BOULEVARD |
| City | LA MESA |
| State | CA |
| Zip Code | 91942 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902453723 | Nicole V Zappelli | Case Manager/Care Coordinator | 4990 William Ave., La Mesa, CA 91942 | 2019-08-26 |
| 1770059834 | Natalie Ngoc Nguyen | Physician Assistant | 5555 Grosmont Center Dr., La Mesa, CA 91942 | 2018-10-16 |
| 1194204297 | Courtney Pietsch | Nurse Practitioner | 8851 Health Center Circle, Suite #603, La Mesa, CA 91942 | 2018-08-09 |
| 1295214773 | Megan Gordon | Behavior Technician | 6116 Horton Dr, La Mesa, CA 91942 | 2018-08-07 |
| 1356836548 | Kimberly Denise Davis | Counselor | 3845 Avocado School Road, El Cajon, CA 91942 | 2018-06-29 |
| 1366932113 | Melanie Joyce Shepard | Physician Assistant | 7051 Alvarado Road, Suite 201, La Mesa, CA 91942 | 2018-05-17 |
| 1871013532 | Low Dental, A.p.c. | Public Health or Welfare | 7872 La Mesa Blvd., La Mesa, CA 91942 | 2017-06-23 |
| 1275069437 | Ardel Ayala | Respiratory Therapist, Registered | 5800 Lake Murray Blvd. Unit 15, La Mesa, CA 91942 | 2017-05-10 |
| 1285007583 | Counseling & Behavioral Specialists | Marriage & Family Therapist | 5520 Wellesley Street, Ste 204, La Mesa, CA 91942 | 2015-11-09 |
| 1285001875 | Emily Shozaki Rizo | Nurse Practitioner | 6285 Meadowcrest Drive, La Mesa, CA 91942 | 2015-08-31 |
| Find all providers in zip 91942 | ||||
| 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 |
|---|---|---|---|---|
| 1104363795 | Senior Coast Living, LLC | Skilled Nursing Facility | 8780 Elden Street, La Mesa, CA 91942-3211 | 2017-01-20 |
| 1235404674 | Caremeridian, LLC | Skilled Nursing Facility | 5640 Aztec Dr, La Mesa, CA 91942-1948 | 2012-03-19 |
| 1003852666 | Elm Holdings, LLC | Skilled Nursing Facility | 3780 Massachusetts Ave, La Mesa, CA 91941-7638 | 2006-06-21 |
| 1225028327 | Community Convalescent Hospital of La Mesa Lp | Skilled Nursing Facility | 8665 La Mesa Blvd, La Mesa, CA 91941 | 2005-10-28 |
| 1356345706 | Ghc of La Mesa, LLC | Skilled Nursing Facility | 7800 Parkway Dr, La Mesa, CA 91942-2001 | 2005-06-13 |
| 1689077588 | Mission Trails Healthcare, Inc. | Skilled Nursing Facility | 8787 Center Dr, La Mesa, CA 91942-3034 | 2014-10-06 |
| 1174926448 | Parkway Operations, LLC | Skilled Nursing Facility | 7760 Parkway Dr, La Mesa, CA 91942-2028 | 2014-10-01 |
| 1679712780 | Flora I Danque Md Inc | Skilled Nursing Facility | 7918 El Cajon Blvd, Suite N322, La Mesa, CA 91942-6719 | 2009-02-12 |
| 1518175231 | Grossmont Ipg Ltd | Skilled Nursing Facility | 5480 Marengo Ave, La Mesa, CA 91942-2408 | 2007-05-18 |
| 1598830556 | Parkway Manor LLC | Skilled Nursing Facility | 7760 Parkway Dr, La Mesa, CA 91942-2028 | 2006-11-22 |
| Find all providers in LA MESA | ||||
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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.