GREENFIELDS INTEMEDIATE CARE FACILITY NPI 1992915953

NPI Information

  • NPI: 1992915953
  • Provider Name: GREENFIELDS INTEMEDIATE CARE FACILITY
  • Classification: Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320600000X
  • Entity Type: Organization
  • Doing Business As: GREENFIELDS III ICF-DDN
  • CLIA Number: 05D0987250
  • Address: 100 MORGAN CT
    VALLEJO, CA
    ZIP 94591
  • Phone: (707) 643-3948

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NPI Details

GREENFIELDS INTEMEDIATE CARE FACILITY is a residential treatment facility, intellectual and/or developmental disabilities in Vallejo, CA. The provider is a residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently. GREENFIELDS INTEMEDIATE CARE FACILITY NPI is 1992915953. The provider is registered as an organization entity type.
The provider Is Doing Business As Greenfields Iii Icf-ddn.

The provider's business location address is:

100 MORGAN CT
VALLEJO, CA
ZIP 94591-452
Phone: (707) 643-3948
Fax: (707) 643-4618

The provider's authorized official is Teresita Reyes .
The authorized official title is Administrator and has the following contact phone number (707) 553-2935.

The CLIA number assigned to this NPI record is 05D0987250 - intermediate care facility for mentally retarded with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/22/2007 and was last updated on 8/15/2007.

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
1320600000XResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesCALIFORNIAYes

What is NPI?

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This page was last updated on: 3/30/2025

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