FILLMORE CONVALESCENT CENTER, LLC (NPI# 1912997016) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912997016 |
| Entity Type | Organization |
| Organization Name | FILLMORE CONVALESCENT CENTER, LLC |
| Practice Address |
118 B St Fillmore CA 93015-1763 |
| Practice Telephone | 8055240083 |
| Practice Fax Number | 8055247260 |
| Mailing Telephone | 8055240083 |
| Mailing Fax Number | 8055247260 |
| Enumeration Date | 2005-10-28 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. ANANIAS EDUARDO GONZALEZ (PRESIDENT/CEO) |
| Authorized Official Telephone | 8055240083 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | CA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | ZZT18866H | 05 |
| Street Address |
118 B ST |
| City | FILLMORE |
| State | CA |
| Zip Code | 93015-1763 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275972481 | Greenfield Care Center of Fillmore LLC | Skilled Nursing Facility | 118 B St, Fillmore, CA 93015-1763 | 2013-06-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003471830 | Sarah Jeanette Ettinger | Student in an Organized Health Care Education/Training Program | Sbcd, Medical Education, 400 W Pueblo Street, Santa Barbara, CA 93015 | 2019-05-07 |
| 1518522341 | Elizabeth Pandian | Student in an Organized Health Care Education/Training Program | Sbch, Medical Education, 400 W Pueblo Street, Santa Barbara, CA 93015 | 2019-05-07 |
| 1407350549 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 328 Central Ave, Fillmore, CA 93015 | 2018-03-22 |
| 1366689358 | Kelly Lynn Brooks | Physician Assistant | 828 Ventura St Ste 100, Fillmore, CA 93015 | 2009-01-13 |
| 1356560718 | Ventura County Behavioral Health | Community/Behavioral Health | 828 W Ventura St Ste 240, Fillmore, CA 93015 | 2007-04-24 |
| 1487726766 | Alejandro Echeverry | Dentist | 1317 Ventura St, Suite C, Fillmore, CA 93015 | 2006-11-14 |
| 1265545321 | Nasr N Anees | Family Medicine | 355 Central Avenue, Clinicas Del Camino Real, Inc, Fillmore, CA 93015 | 2006-08-15 |
| 1487219358 | Roxana Ardebili | Student in an Organized Health Care Education/Training Program | Sbch, Medical Education, 400 W Pueblo Street, Santa Barbara, CA 93015 | 2019-05-07 |
| 1235794009 | Philip Wan | Student in an Organized Health Care Education/Training Program | Sbch, Medical Education, 400 W Pueblo Street, Santa Barbara, CA 93015 | 2019-05-07 |
| 1679138531 | Gretel Dayna D'souza | Student in an Organized Health Care Education/Training Program | Sbch, Medical Education, 400 W Pueblo Street, Santa Barbara, CA 93015 | 2019-05-07 |
| Find all providers in zip 93015 | ||||
| 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 |
|---|---|---|---|---|
| 1275972481 | Greenfield Care Center of Fillmore LLC | Skilled Nursing Facility | 118 B St, Fillmore, CA 93015-1763 | 2013-06-20 |
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| 1043837966 | Desert Ridge Transitional Care Center, Lp | Skilled Nursing Facility | 13300 11th Avenue, Victorville, CA 92395 | 2020-06-26 |
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| 1861018327 | Covina Clhf Corporation | Skilled Nursing Facility | 1411 S Sandia Ave, West Covina, CA 91790-3309 | 2020-06-22 |
| 1780204024 | Neighbor Care Congregate Home, Inc. | Skilled Nursing Facility | 3249 Gerald Dr, Newbury Park, CA 91320-2948 | 2020-04-16 |
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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.