WINTER HAVEN NPI 1154392181

NPI Information

  • NPI: 1154392181
  • Provider Name: WINTER HAVEN
  • Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
  • Entity Type: Organization
  • CLIA Number: 05D1080645
  • Address: 546 CENTRAL AVE
    FILLMORE, CA
    ZIP 93015
  • Phone: (805) 524-3040

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NPI Details

WINTER HAVEN is an intermediate care facility mentally retarded in Fillmore, CA. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. WINTER HAVEN NPI is 1154392181. The provider is registered as an organization entity type.

The provider's business location address is:

546 CENTRAL AVE
FILLMORE, CA
ZIP 93015-332
Phone: (805) 524-3040
Fax: (805) 524-3040

The provider's authorized official is Kathleen Elbanowski .
The authorized official title is Ceo/cfo and has the following contact phone number (805) 525-0305.

The CLIA number assigned to this NPI record is 05D1080645 - intermediate care facility for mentally retarded with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/28/2006 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1315P00000XIntermediate Care Facility, Intellectual DisabilitiesCALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1LTC60945FMEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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