FOREST HILL (CALIFORNIA NEVADA METHODIST HOMES) NPI 1639324478

Skilled Nursing Facility in Pacific Grove, CA

NPI 1639324478 Organization Skilled Nursing Facility CLIA Number 05D2017325 CLIA Certificate of Waiver

About FOREST HILL (CALIFORNIA NEVADA METHODIST HOMES)

Forest Hill (california Nevada Methodist Homes) is a provider established in Pacific Grove, California specializing in skilled nursing facility. The NPI number of Forest Hill (california Nevada Methodist Homes) is 1639324478 and was assigned on November 2008. The practitioner's primary taxonomy code is 314000000X with license number 550001102 (CA). The provider is registered as an organization and their NPI record was last updated 9 years ago. The provider's is doing business as Forest Hill. The authorized official of this NPI record is Robert Hubbard (President)

The CLIA number of Forest Hill is 05D2017325 registered as a "skilled nursing/nursing facility" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to Forest Hill 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

1639324478

Provider NameFOREST HILL (CALIFORNIA NEVADA METHODIST HOMES)
Provider Location Address551 GIBSON AVE PACIFIC GROVE, CA 93950
Provider Mailing Address201 19TH ST SUITE 100 OAKLAND, CA 94612
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Other Organization NameFOREST HILL
Other Name TypeDoing Business As (3)
Enumeration Date11-20-2008
Last Update Date08-05-2013


Primary Taxonomy

Taxonomy Code314000000X
ClassificationSkilled Nursing Facility
TypeNursing & Custodial Care Facilities
License No.550001102
License StateCA
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.

Business Address

FOREST HILL
551 GIBSON AVE
PACIFIC GROVE, CA
ZIP 93950
Phone: (831) 657-5200
Fax: (831) 649-1695

Get Directions


Mailing Address

FOREST HILL
201 19TH ST
SUITE 100
OAKLAND, CA
ZIP 94612
Phone: (510) 893-8989
Fax: (510) 893-3041



Authorized Official

Authorized Official Name ROBERT HUBBARD
Authorized Official TitlePRESIDENT
Authorized Official Phone(510) 893-8989

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 1639324478 is:

CLIA Number05D2017325
Facility TypeSKILLED NURSING/NURSING FACILITY
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
55-5867MEDICARE UPIN (02)

Other Providers at the same location


The following 3 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1306465323 SCOTT STABILE PTA
Individual
Physical Therapy Assistant551 GIBSON AVE
PACIFIC GROVE, CA 93950
(831) 657-5200
1407523921 KATELYN THORUP
Individual
Speech-Language Pathologist551 GIBSON AVE
PACIFIC GROVE, CA 93950
(831) 250-9634
1588331417 ELICIA BROWN MS, OTR/L
Individual
Occupational Therapist551 GIBSON AVE
PACIFIC GROVE, CA 93950
(831) 646-6495

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
The code describing 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.