BENNETT VALLEY ICF DDH INC
NPI 1326198524
Intermediate Care Facility, Intellectual Disabilities in Santa Rosa, CA
NPI Status: Active since January 11, 2007
Contact Information
2416 CACTUS AVENUE
SANTA ROSA, CA
ZIP 95405
Phone: (707) 544-6465
Fax: (650) 347-8887
- Organization
- Intermediate Care Facility, Intellectual...
- CLIA Number: 05D0998299
- CLIA Cert. Type: Intermediate Care Facility for Mentally Retarded
- CLIA Exp. Date: 04-10-2026
About BENNETT VALLEY ICF DDH INC
This page provides the complete NPI Profile along with additional information for Bennett Valley Icf Ddh Inc, a provider established in Santa Rosa, California operating as a Intermediate Care Facility, Intellectual Disabilities. The healthcare provider is registered in the NPI registry with number 1326198524 assigned on January 2007. The practitioner's primary taxonomy code is 315P00000X. The provider is registered as an organization and their NPI record was last updated 5 years ago. The authorized official of this NPI record is Mrs. Julie G Albero (Director)
- NPI
- 1326198524
- Provider Name
- BENNETT VALLEY ICF DDH INC
- Entity Type
- Organization
- Location Address
- 2416 CACTUS AVENUE SANTA ROSA, CA 95405
- Location Phone
- (707) 544-6465
- Location Fax
- (650) 347-8887
- Mailing Address
- 2040 SEA CLIFF WAY SAN BRUNO, CA 94066
- Mailing Phone
- (650) 544-8999
- Mailing Fax
- (650) 347-8887
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 01-11-2007
- Last Update Date
- 08-22-2020
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Intermediate Care Facility, Intellectual Disabilities
- Taxonomy Code
- 315P00000X
- Type
- Nursing & Custodial Care Facilities
- License State
- CA
- Taxonomy Description
- An intermediate care facility providing services for individuals with intellectual disabilities.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 55 G072 | OTHER (01) | CA | MEDICAL |
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 this NPI number is:
- CLIA Number
- 05D0998299
- Facility Type
- Intermediate Care Facility for Mentally Retarded
- Certificate Effective Date
- April 11, 2024
- Certificate Expiration Date
- April 10, 2026
- Laboratory Director
- RONALD BYLEDBAL
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Bennett Valley Icf Ddh Inc 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.
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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. | |||||||||
| 1 | 3 | 2 | 6 | 1 | 9 | 8 | 5 | 2 | 4 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 3 | 4 | 6 | 2 | 9 | 16 | 5 | 4 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 3 + 4 + 6 + 2 + 9 + 1 + 6 + 5 + 4 + 24 = 66 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 66 = 4 | 4 | ||||||||
The NPI number 1326198524 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1326198524, enumerated as an "organization" on January 11, 2007.
The provider is located at 2416 CACTUS AVENUE SANTA ROSA, CA 95405 and the phone number is (707) 544-6465.
Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
