CENTENNIAL HEALTHCARE LLC


Address: 7504 Capps Ave, Reseda, CA 91335-2710
Phone: 8188811182

CENTENNIAL HEALTHCARE LLC (NPI# 1669886230) 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) 1669886230
Entity Type Organization
Organization Name CENTENNIAL HEALTHCARE LLC
Other Organization Name GATEWAY HOMES
Practice Address 7504 Capps Ave
Reseda
CA 91335-2710
Practice Telephone 8188811182
Practice Fax Number 5622681608
Mailing Telephone 8188811182
Mailing Fax Number 5622681608
Enumeration Date 2014-06-11
Last Update Date 2014-06-11
Authorized Official Name HARRY JACOBS (MANAGER)
Authorized Official Telephone 8188811182
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 3140N1450X Skilled Nursing Facility
Specialization: Nursing Care, Pediatric
550000738 CA Nursing & Custodial Care Facilities

Other Provider/Organization Names

Other Name Type Code
gateway homes Doing Business As Name - Organization

Office Location

Street Address 7504 CAPPS AVE
City RESEDA
State CA
Zip Code 91335-2710

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Taxonomy Information

Taxonomy Code 3140N1450X
Grouping Nursing & Custodial Care Facilities
Classification Skilled Nursing Facility
Specialization Nursing Care, Pediatric

Taxonomy Definition

A nursing care facility designed and staffed for the provision of nursing care and appropriate educational and habilitative/rehabilitative services to children with multiple, complex or profound disabilities that can not be cared for in a less restrictive environment.
Notes: [7/1/2003: new]

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NPI Name Taxonomy Address Enumeration
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1740736198 Corwin Kids Healthcare Inc Skilled Nursing Facility 18747 Corwin Rd, Apple Valley, CA 92307-2303 2016-08-26
1073914412 Crosspeaks Services, Inc. Skilled Nursing Facility 1350 Teal Hollow Dr, Yuba City, CA 95993-8885 2014-09-04
1851660682 George Nobuhiko Tobo Skilled Nursing Facility 16423 Harbor Blvd, Fountain Valley, CA 92708-1367 2011-12-22
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1033417167 Wee Hearts Skilled Nursing Facility 10049 Magnolia Blvd, 539, N Hollywood, CA 91606 2011-03-15
1720300783 Kidz Kingdom Pdhc Skilled Nursing Facility 13022 Sherman Way, North Hollywood, CA 91605-4955 2010-02-18
1285884411 Twins Services and Training Center Skilled Nursing Facility 22910 Teil Glen Rd, Wildomar, CA 92595-8099 2008-09-24
1437312055 Kitty's Skilled Nursing Facility 7655 Laurie Way, 7655 Laurie Way, Sacramento, CA 95832-1514 2008-07-03
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Competitor

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City RESEDA
Zip Code 91335

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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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