CRESTWOOD BEHAVIORAL HEALTH, INC. (NPI# 1508884487) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508884487 |
| Entity Type | Organization |
| Organization Name | CRESTWOOD BEHAVIORAL HEALTH, INC. |
| Other Organization Name | CRESTWOOD MANOR |
| Practice Address |
1400 Celeste Dr Modesto CA 95355-5041 |
| Mailing Address |
7590 Shoreline Dr Stockton CA 95219-5455 |
| Practice Telephone | 2095268050 |
| Practice Fax Number | 2095230652 |
| Mailing Telephone | 2099552328 |
| Mailing Fax Number | 2099525314 |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2015-05-19 |
| Authorized Official Name | LORI BLACKBURN (VICE PRESIDENT) |
| Authorized Official Telephone | 2099552322 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | ZZR18515H | 05 |
| Other Name | Type Code |
|---|---|
| CRESTWOOD MANOR | Doing Business As Name - Organization |
| 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 |
| 1023495181 | Crestwood Behavioral Health, Inc. | Intermediate Care Facility, Mental Illness | 960 Third Ave, Chula Vista, CA 91911 | 2015-04-28 |
| 1295146934 | Crestwood Behavioral Health, Inc. | Intermediate Care Facility, Mental Illness | 5550 University Ave Ste A, San Diego, CA 92105 | 2014-05-15 |
| 1780009142 | Crestwood Behavioral Health, Inc. | Psychiatric Hospital | 2201 Tuolumne St Ste B, Vallejo, CA 94589-2524 | 2014-02-21 |
| 1669734075 | Crestwood Behavioral Health, Inc. | Psychiatric Hospital | 2600 Stockton Blvd Ste B, Sacramento, CA 95817-2210 | 2012-06-12 |
| 1194034645 | Crestwood Behavioral Health, Inc. | Psychiatric Hospital | 6700 Eucalyptus Dr Ste C, Bakersfield, CA 93306-6075 | 2010-10-01 |
| 1821269093 | Crestwood Behavioral Health, Inc. | Psychiatric Hospital | 6700 Eucalyptus Dr, Suite B, Bakersfield, CA 93306-6075 | 2008-03-17 |
| 1275668840 | Crestwood Behavioral Health, Inc. | Clinic/Center | 409 N Adams St, Dixon, CA 95620-2925 | 2007-02-22 |
| 1073648747 | Crestwood Behavioral Health, Inc. | Clinic/Center | 1945 Kidder Ave, Fairfield, CA 94533-3919 | 2007-02-22 |
| 1356411656 | Crestwood Behavioral Health, Inc. | Intermediate Care Facility, Mental Illness | 2600 Stockton Blvd, Sacramento, CA 95817-2210 | 2006-11-08 |
| Street Address |
1400 CELESTE DR |
| City | MODESTO |
| State | CA |
| Zip Code | 95355-5041 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639202948 | Stanislaus County | Community/Behavioral Health | 1400 Celeste Dr, Modesto, CA 95355-5041 | 2007-03-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982211793 | I To I LLC | Optometrist | 3401 Oakdale Rd, Ste 525, Modesto, CA 95355 | 2020-09-25 |
| 1205443116 | Altwal and Shelat Dds Inc | Dentist | 1317 Oakdale Road, Suite 310, Modesto, CA 95355 | 2020-09-24 |
| 1184255911 | Reeves, D.d.s. and Lavalley, D.d.s., A Dental Corporation | Clinic/Center | 3401 Oakdale Road, Suite 505, Modesto, CA 95355 | 2020-01-30 |
| 1487133856 | Natalie Vargas | Behavior Technician | 1317 Oakdale Road Suite 610, Modesto, CA 95355 | 2018-08-07 |
| 1871079152 | Jill H Fusia | Dietitian, Registered | 1404 Cordero Court, Modesto, CA 95355 | 2018-07-19 |
| 1043727514 | Emily Lauren Schaefer | Behavioral Analyst | 3425 Coffee Rd Ste C2, Modesto, CA 95355 | 2018-01-05 |
| 1376083691 | Hari Gnanasekeram, PC | Technician, Cardiology | 1303 Mable Avenu, Modesto, CA 95355 | 2017-03-06 |
| 1598139891 | Encompass Health Rehabilitation Hospital of Modesto, LLC | Rehabilitation Hospital | 1303 Mable Avenue, Modesto, CA 95355 | 2015-11-24 |
| 1013387844 | Diana Faith Kigenyi | Social Worker | 1225 Oakdale Road, Modesto, CA 95355 | 2015-10-06 |
| 1437530672 | Tzu Yi Wei | Acupuncturist | 2209 Coffee Road, Suite A, Modesto, CA 95355 | 2015-06-12 |
| Find all providers in zip 95355 | ||||
| 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 |
|---|---|---|---|---|
| 1437291929 | Covenant Care California, LLC | Skilled Nursing Facility | 3620 Dale Rd, Suite B, Modesto, CA 95356-0598 | 2007-02-13 |
| 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 |
| 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.