LAUREL PARK BEHAVIORAL HEALTH CENTER
NPI 1639126782
Skilled Nursing Facility in Pomona, CA
NPI Status: Active since May 27, 2006
Contact Information
1425 LAUREL AVE
POMONA, CA
ZIP 91768
Phone: (909) 622-1069
Fax: (909) 622-4319
- Organization
- Skilled Nursing Facility
- CLIA Number: 05D0886201
- CLIA Cert. Type: Waiver
- CLIA Exp. Date: 05-13-2026
About LAUREL PARK BEHAVIORAL HEALTH CENTER
Laurel Park Behavioral Health Center is a provider established in Pomona, California operating as a Skilled Nursing Facility. The healthcare provider is registered in the NPI registry with number 1639126782 assigned on May 2006. The practitioner's primary taxonomy code is 314000000X with license number 950000064 (CA). The provider is registered as an organization and their NPI record was last updated 8 years ago. The provider's is doing business as Laurel Park Behavioral Health Center. The authorized official of this NPI record is Michael T. Berg (Assistant Secretary)
- NPI
- 1639126782
- Provider Legal Name
- SUNBRIDGE BRASWELL ENTERPRISES LLC
- Other Organization Name
- LAUREL PARK BEHAVIORAL HEALTH CENTER
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 1425 LAUREL AVE POMONA, CA 91768
- Location Phone
- (909) 622-1069
- Location Fax
- (909) 622-4319
- Mailing Address
- 101 SUN AVE NE COMPLIANCE DEPARTMENT ALBUQUERQUE, NM 87109
- Mailing Phone
- (505) 468-5604
- Mailing Fax
- (909) 622-4319
- Is Sole Proprietor?
- N/A
- Is Organization Subpart?
- Yes
- Enumeration Date
- 05-27-2006
- Last Update Date
- 01-14-2016
- Code Navigator
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
Skilled Nursing Facility
- Taxonomy Code
- 314000000X
- Type
- Nursing & Custodial Care Facilities
- License No.
- 950000064
- License State
- CA
- Taxonomy Description
- (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.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Medicare
Medicaid
*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 |
|---|---|---|---|
| ZZT18548G | MEDICAID (05) | CA |
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
- 05D0886201
- Facility Type
- Skilled Nursing Facility/Nursing Facility
- Certificate Effective Date
- May 14, 2024
- Certificate Expiration Date
- May 13, 2026
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Laurel Park Behavioral Health Center 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 | 6 | 3 | 9 | 1 | 2 | 6 | 7 | 8 | 2 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 6 | 6 | 9 | 2 | 2 | 12 | 7 | 16 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 6 + 6 + 9 + 2 + 2 + 1 + 2 + 7 + 1 + 6 + 24 = 68 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 68 = 2 | 2 | ||||||||
The NPI number 1639126782 is valid because the calculated check digit 2 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 1639126782, enumerated in the NPI registry as an "organization" on May 27, 2006
The provider is located at 1425 Laurel Ave Pomona, Ca 91768 and the phone number is (909) 622-1069
This medical organization specializes in Skilled Nursing Facility with taxonomy code 314000000X
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 05D0886201 for a "skilled nursing facility/nursing facility" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued 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..
This NPI record was last updated on May 27, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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