LAKESIDE SPECIAL CARE CENTER
NPI 1790789170
Skilled Nursing Facility in Lakeside, CA

Active since June 13, 2005CLIA 05D0893434 · Waiver
5/5
Overall Rating
11962 WOODSIDE AVE, LAKESIDE, CA 92040(619) 561-1222(619) 390-9487 Get Directions Write a Review

NPPES record last updated: August 5, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 5, 2024, Aug 3, 2022 (2 updates tracked since 2022).

About Lakeside Special Care Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LAKESIDE SPECIAL CARE CENTER (NPI 1790789170) is a healthcare organization registered as a skilled nursing facility in Lakeside, California and active in the NPI registry since June 2005. The organization holds a CLIA Waiver certificate valid through October 21, 2026 and lists Lois Mastrocola, Chief Financial Officer, as its authorized official.

NPPES Registry Identity

NPI1790789170
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameGHC OF LAKESIDE, LLC
Location Address11962 WOODSIDE AVELakeside, CA 92040-2914
Mailing Address11962 Woodside AveLakeside, CA 92040-2914 · (619) 561-1222 · Fax (619) 390-9487
Fax(619) 390-9487
Organization SubpartNo
Authorized OfficialLois MastrocolaChief Financial Officer · (714) 241-5600
Enumeration DateJune 13, 2005
Last NPPES UpdateAugust 5, 20242 updates tracked since enumeration
NPPES CertifiedAugust 1, 2024
NPI 1790789170 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License Licensed in CA · 080000111
Definition
(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.
11962 WOODSIDE AVE, Lakeside, CA 92040

Other Names 1

Doing Business AsLakeside Special Care Center

Other Identifiers 1

MedicaidZZT18594HCA

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D0893434

Ghc Of Lakeside, LLC Dba Lakeside Special Care Center · Lakeside, CA
Active · expires Oct 21, 2026
CLIA Number05D0893434
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateOctober 22, 2024
Certificate Expiration DateOctober 21, 2026
Laboratory DirectorJon Highum
Laboratory Phone(619) 561-1222
Laboratory LocationGhc Of Lakeside, LLC Dba Lakeside Special Care Center11962 Woodside Avenue, Lakeside, CA 92040
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Nursing Home Quality Ratings CMS Care Compare

Quality ratings, staffing and inspection history for Lakeside Special Care Center (CMS certification number 555887), from CMS Care Compare.

Lakeside Special Care Center

Nursing home · Lakeside, CA
5/5 CMS Overall Rating
OwnershipFor profit - Limited Liability company
CMS Certification Number555887
Certified Beds94 beds93 residents per day on average
Medicare & Medicaid Participant SinceJune 2, 2014
Resident & Family CouncilResident council
Automatic sprinkler system

CMS Star Ratings

Quality Measures
Based on a select set of clinical quality measures.
5/5
Long-Stay Quality
Quality of care delivered to long-term residents.
5/5
Staffing
Based on nursing staff hours relative to resident needs.
4/5
Weighted Health Inspection Score
Lower scores are better; the score summarizes deficiencies found on recent inspections.
24
Ratings are assigned by CMS on a one-to-five star scale; five is the highest. Categories without a current CMS rating are not shown.

Staffing & Turnover

Total Nurse Staffing
nurse aide 2.69 · LPN 1.19 · RN 0.35
4.23 hrs per resident per day
Weekend Nurse Staffing
3.37 hrs per resident per day
Physical Therapist Staffing
0.05 hrs per resident per day
Nursing Staff Turnover
Share of nursing staff who left the facility within the past year.
39.4%
Registered Nurse Turnover
55.6%
Administrators Who Have Left
In the past year.
0
Higher staffing hours generally allow more direct care time per resident.

Inspections & Enforcement

Facility-Reported Incidents
4
Substantiated Complaints
0
Fines
0
Medicare Payment Denials
0
Total Penalties
0
Counts come from CMS inspections and complaint investigations over approximately the past three years. CMS Care Compare data as of October 1, 2024.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Occupational Therapist
11962 WOODSIDE AVE
LAKESIDE, CA 92040
Licensed Vocational Nurse
11962 WOODSIDE AVE
LAKESIDE, CA 92040
Psychologist (Clinical)
11962 WOODSIDE AVE
LAKESIDE, CA 92040

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ghc Of Lakeside, LLC's NPI number?

The NPI number for Ghc Of Lakeside, LLC is 1790789170. It was assigned to this organization in the NPPES registry on June 13, 2005. The provider is doing business as Lakeside Special Care Center.

Where is Ghc Of Lakeside, LLC located?

Ghc Of Lakeside, LLC is located at 11962 Woodside Ave, Lakeside, CA 92040. The listed phone number is (619) 561-1222.

What is Ghc Of Lakeside, LLC's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does Ghc Of Lakeside, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D0893434) is associated with this NPI, valid through October 21, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is Ghc Of Lakeside, LLC a Medicare-certified nursing home?

Yes. Lakeside Special Care Center is a Medicare-certified nursing home with 94 certified beds.

What quality rating does Ghc Of Lakeside, LLC have?

CMS rates Lakeside Special Care Center 5 out of 5 stars overall on Care Compare. The full measure detail is in the Nursing Home Quality Ratings section above.

When was this NPI record last updated?

The NPPES record for Ghc Of Lakeside, LLC was last updated on August 5, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.