PALM TREE RANCH NPI 1265891691

Substance Abuse Rehabilitation Facility in Herald, CA

Organization Substance Abuse Rehabilitation Facility CLIA Number 05D2111973 CLIA Certificate of Waiver

About PALM TREE RANCH

Palm Tree Ranch is a provider established in Herald, California specializing in Substance Abuse Rehabilitation Facility. The NPI number of Palm Tree Ranch is 1265891691 and was assigned on February 2016. The practitioner's primary taxonomy code is 324500000X with license number 340100BP (CA). The provider is registered as an organization and their NPI record was last updated 7 years ago. The provider's other name is Palm Tree Ranch. The authorized official of this NPI record is Dr. Mark Francis Towns M.d. (Program Director)

The CLIA number of Palm Tree Ranch is 05D2111973 registered as a "other" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to Palm Tree Ranch to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

NPI

1265891691

Provider NamePALM TREE RANCH
Provider Location Address12370 CLAY STATION RD HERALD, CA 95638
Provider Mailing Address768 GRIFFEY WAY GALT, CA 95632
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Other Organization NamePALM TREE RANCH
Other Name TypeOther Name (5)
Enumeration Date02-13-2016
Last Update Date02-13-2016


Primary Taxonomy

Taxonomy Code324500000X
ClassificationSubstance Abuse Rehabilitation Facility
TypeResidential Treatment Facilities
License No.340100BP
License StateCA
Taxonomy DescriptionA facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

Business Address

PALM TREE RANCH
12370 CLAY STATION RD
HERALD, CA
ZIP 95638
Phone: (209) 748-2628

Get Directions


Mailing Address

PALM TREE RANCH
768 GRIFFEY WAY
GALT, CA
ZIP 95632
Phone: (916) 612-2452
Fax: (209) 740-4966


Authorized Official

Authorized Official NameDR. MARK FRANCIS TOWNS M.D.
Authorized Official TitlePROGRAM DIRECTOR
Authorized Official Phone(916) 612-2452

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1265891691 is:

CLIA Number05D2111973
Facility TypeOTHER
Certificate TypeCertificate of Waiver

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
=========OTHER (01)CAEIN

NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1265891691
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
221251692618
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 2 + 1 + 2 + 5 + 1 + 6 + 9 + 2 + 6 + 1 + 8 + 24 = 69
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 69 = 11

The NPI number 1265891691 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the same location


The following provider is registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1720284912MS. VIVIAN LYNNE WRIGHT
Individual
Counselor (Addiction (Substance Use Disorder))12370 CLAY STATION RD
HERALD, CA 95638
(209) 744-9909

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
Palm Tree Ranch is registered as an entity type code: 2. The entity type code describes the type of health care provider that is being assigned an NPI. The entity type codes are:

  • 1 = Person: individual human being who furnishes health care.
  • 2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.