ANTELOPE HILLS MANOR ICF DDN INC (NPI# 1770622292) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1770622292 |
Entity Type | Organization |
Organization Name | ANTELOPE HILLS MANOR ICF DDN INC |
Other Organization Name | KLAMATH HOME ICF DDN |
Practice Address |
7704 Antelope Hills Dr Antelope CA 95843-2491 |
Practice Telephone | 9167211517 |
Practice Fax Number | 9167210762 |
Mailing Telephone | 9167211517 |
Mailing Fax Number | 9167210762 |
Enumeration Date | 2007-02-05 |
Last Update Date | 2020-08-22 |
Authorized Official Name | MR. ANTONIO GAGANTE RANIT (RN ADMINISTRATOR QMRP) |
Authorized Official Telephone | 9167219439 |
Authorized Official Credential | REGISTERED NURSE |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | Nursing & Custodial Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CA | LTC80334F | 05 | |
CA | LTC80373F | 05 |
Other Name | Type Code |
---|---|
klamath home icf ddn | Doing Business As Name - Organization |
Street Address |
7704 ANTELOPE HILLS DR |
City | ANTELOPE |
State | CA |
Zip Code | 95843-2491 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1881196350 | Attayla Marnyce Bell | Behavior Technician | 8438 Cedar Hill Ct, Antelope, CA 95843 | 2018-03-01 |
1699297259 | Alexej Iovita | Nursing Home Administrator | 4136 Singing Tree Way, Antelope, CA 95843 | 2017-07-14 |
1447386362 | Rescare California, Inc. | Intermediate Care Facility, Mentally Retarded | 8141 Chimango Way, Antelope, CA 95843 | 2007-02-26 |
1144373838 | Cynthia Louise Simpson | Dental Hygienist | 8124 Sheehan Way, Antelope, CA 95843 | 2007-01-18 |
1750471140 | Dental Corporation of Ghazal Buehler Rodgers | Dentist | 8008 Walerga Rd, Ste. 100, Antelope, CA 95843 | 2006-10-13 |
1235245168 | Vimal Amral Dulabh | Dentist | 3535 Elverta Rd, Suite E, Antelope, CA 95843 | 2006-08-22 |
1073987269 | Rex Anthony Gamoke | Pharmacist | 4331 Antelope Rd, Antelope, CA 95843 | 2015-11-25 |
1134302524 | Firstsight Vision Services, Inc. | Optometrist | 5821 Antelope North Rd, Antelope, CA 95843 | 2007-12-10 |
1386116630 | Juliya Sitaruk | Behavior Technician | 3015 Scotland Dr, Antelope, CA 95843-1928 | 2018-12-27 |
1861672057 | Firstsight Vision Services, Inc. | Optometrist | 7901 Watt Ave, Antelope, CA 95843-2000 | 2007-11-06 |
Find all providers in zip 95843 |
Taxonomy Code | 315P00000X |
Grouping | Nursing & Custodial Care Facilities |
Classification | Intermediate Care Facility, Mentally Retarded |
(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528386786 | Antelope Hills Manor Icf/dd-n Inc. | Intermediate Care Facility, Mentally Retarded | 8533 Tullia Pl, Antelope, CA 95843-5986 | 2010-05-12 |
1447386362 | Rescare California, Inc. | Intermediate Care Facility, Mentally Retarded | 8141 Chimango Way, Antelope, CA 95843 | 2007-02-26 |
1871629121 | Res-care California, Inc. | Intermediate Care Facility, Mentally Retarded | 8525 Meandering Way, Antelope, CA 95843-5863 | 2007-02-23 |
1487781159 | Res-care California, Inc. | Intermediate Care Facility, Mentally Retarded | 8525 Meandering Way, Antelope, CA 95843-5863 | 2007-02-28 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1215545538 | Vine Valley Homes II | Intermediate Care Facility, Mentally Retarded | 8400 Bellingham Ave, Sun Valley, CA 91352-3803 | 2020-07-22 |
1841811791 | Young Walker Inc. | Intermediate Care Facility, Mentally Retarded | 14 Deer Ct, Sacramento, CA 95823-4402 | 2020-05-01 |
1003441155 | Sunrise Premier Homes LLC | Intermediate Care Facility, Mentally Retarded | 13831 Ruther Ave, Paramount, CA 90723-2662 | 2020-03-10 |
1649805912 | Jingma Inc | Intermediate Care Facility, Mentally Retarded | 34909 Osprey Dr, Union City, CA 94587-4618 | 2020-03-07 |
1124661699 | Rscr California, Inc. | Intermediate Care Facility, Mentally Retarded | 581 S Gilmar St, Anaheim, CA 92802-1306 | 2019-10-28 |
1467095935 | Rscr California, Inc. | Intermediate Care Facility, Mentally Retarded | 1592 W Lorane Way, Anaheim, CA 92802-3930 | 2019-10-28 |
1992348460 | Rscr California, Inc. | Intermediate Care Facility, Mentally Retarded | 5940 Los Angeles Way, Buena Park, CA 90620-2723 | 2019-10-28 |
1578106043 | Rscr California, Inc. | Intermediate Care Facility, Mentally Retarded | 2918 E Greenhedge Ave, Anaheim, CA 92806-3804 | 2019-10-28 |
1790328680 | Rscr California, Inc. | Intermediate Care Facility, Mentally Retarded | 2143 W Fir Ave, Anaheim, CA 92801-3436 | 2019-10-23 |
1356984249 | Rscr California, Inc. | Intermediate Care Facility, Mentally Retarded | 6540 Christine Cir, Buena Park, CA 90620-4511 | 2019-10-23 |
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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.