GRANCARE LLC (NPI# 1811969355) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811969355 |
| Entity Type | Organization |
| Organization Name | GRANCARE LLC |
| Other Organization Name | CREEKSIDE HEALTHCARE CENTER |
| Practice Address |
1900 Church Ln San Pablo CA 94806-3708 |
| Practice Telephone | 5102355514 |
| Mailing Telephone | 5102355514 |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2013-09-10 |
| Authorized Official Name | MRS. ANDREA SAAVEDRA (DIRECTOR OF ACCOUNTS RECEIVABLE) |
| Authorized Official Telephone | 7072081940 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 314000000 | CA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | LTC05099I | 05 |
| Other Name | Type Code |
|---|---|
| Creekside Healthcare Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609840115 | Grancare LLC | Skilled Nursing Facility | 27350 Tampa Ave, Hayward, CA 94544-4429 | 2006-02-14 |
| 1679546915 | Grancare LLC | Skilled Nursing Facility | 4109 Emerald St, Torrance, CA 90503-3105 | 2006-02-08 |
| 1851364194 | Grancare LLC | Skilled Nursing Facility | 3050 Montrose Ave, La Crescenta, CA 91214-3619 | 2006-02-08 |
| 1487627725 | Grancare LLC | Skilled Nursing Facility | 19700 Hesperian Blvd, Hayward, CA 94541-4704 | 2006-02-08 |
| 1720051295 | Grancare LLC | Skilled Nursing Facility | 1320 20th St, Santa Monica, CA 90404-2034 | 2006-02-07 |
| 1083687560 | Grancare LLC | Skilled Nursing Facility | 1338 20th St, Santa Monica, CA 90404-2034 | 2006-02-07 |
| 1548232150 | Grancare LLC | Nursing Facility/Intermediate Care Facility | 675 24th Ave, Santa Cruz, CA 95062-4205 | 2006-02-07 |
| 1518939016 | Grancare LLC | Skilled Nursing Facility | 8925 Mines Ave, Pico Rivera, CA 90660-3006 | 2006-02-07 |
| 1902879471 | Grancare LLC | Skilled Nursing Facility | 2065 Forest Ave, San Jose, CA 95128-4807 | 2006-02-07 |
| 1023080660 | Grancare LLC | Skilled Nursing Facility | 3032 Rowena Ave, Los Angeles, CA 90039-2005 | 2006-02-07 |
| Street Address |
1900 CHURCH LN |
| City | SAN PABLO |
| State | CA |
| Zip Code | 94806-3708 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588082416 | California Emergency Physicians Medical Group A Professional Corp | Internal Medicine | 1900 Church Ln, San Pablo, CA 94806-3708 | 2014-03-28 |
| 1306269386 | Creekside Operating Company Lp | Skilled Nursing Facility | 1900 Church Ln, San Pablo, CA 94806-3708 | 2014-01-28 |
| 1245450691 | Rina Viacrucis | Physical Therapist | 1900 Church Ln, San Pablo, CA 94806-3708 | 2007-04-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013574375 | Alejandra Valle | Behavior Technician | 2970 Hilltop Mall Rd Suite 104, Richmond, CA 94806 | 2019-05-22 |
| 1629535042 | Kaitlin Sue Oshiro | Specialist/Technologist | 16401 San Pablo Ave. Spc 153, San Pablo, CA 94806 | 2019-02-21 |
| 1114400561 | Alan Gonzalez | Pharmacist | 13691 San Pablo Ave., San Pablo, CA 94806 | 2018-09-12 |
| 1265918783 | Laurel Dunn | Student in an Organized Health Care Education/Training Program | 15501 San Pablo Ave # G317, Richmond, CA 94806 | 2018-07-17 |
| 1720503592 | Monika Tippie | Marriage & Family Therapist | West County Adult Mental Health, 13585 San Pablo Ave, 2nd Floor, San Pablo, CA 94806 | 2017-08-14 |
| 1225553902 | Charles Marco Aquilina | Student in an Organized Health Care Education/Training Program | Y Team, 3260 Blume Dr., Suite 450, Richmond, CA 94806 | 2017-08-03 |
| 1922538545 | Hui-teh Hsu | Pharmacist | 2714 Holly St, San Pablo, CA 94806 | 2017-06-15 |
| 1063942878 | Meng-ju Yang | Student in an Organized Health Care Education/Training Program | 3260 Blume Dr., Suite 450, Richmond, CA 94806 | 2017-06-14 |
| 1346780020 | Mae Mayfield | Social Worker | 3600 Sierra Ridge Drive Apt # 7304, Richmond, CA 94806 | 2017-03-01 |
| 1487000790 | Pasha Jackson | Family Medicine | 2970 Hilltop Mall Rd Ste 304, Richmond, CA 94806 | 2016-05-05 |
| Find all providers in zip 94806 | ||||
| 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 |
|---|---|---|---|---|
| 1811036957 | Sp Facility Inc | Skilled Nursing Facility | 13328 San Pablo Ave, San Pablo, CA 94806-3902 | 2007-02-05 |
| 1932172491 | Grancare LLC | Skilled Nursing Facility | 13484 San Pablo Ave, San Pablo, CA 94806-3904 | 2006-02-07 |
| 1376966861 | Vale Operating Company Lp | Skilled Nursing Facility | 13484 San Pablo Ave, San Pablo, CA 94806-3904 | 2014-02-04 |
| 1306269386 | Creekside Operating Company Lp | Skilled Nursing Facility | 1900 Church Ln, San Pablo, CA 94806-3708 | 2014-01-28 |
| 1821320417 | San Pablo Healthcare & Wellness Center LLC | Skilled Nursing Facility | 13328 San Pablo Ave, San Pablo, CA 94806-3902 | 2010-02-05 |
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| 1780204024 | Neighbor Care Congregate Home, Inc. | Skilled Nursing Facility | 3249 Gerald Dr, Newbury Park, CA 91320-2948 | 2020-04-16 |
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| Find all providers with the same taxonomy | ||||
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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.