Provider Demographics
NPI:1780204024
Name:NEIGHBOR CARE CONGREGATE HOME, INC.
Entity Type:Organization
Organization Name:NEIGHBOR CARE CONGREGATE HOME, INC.
Other - Org Name:LINK TO CARE CONGREGATE HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:VERGEL DE DIOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-268-0989
Mailing Address - Street 1:2955 E HILLCREST DRIVE
Mailing Address - Street 2:SUITE 128
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91362
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3249 GERALD DR
Practice Address - Street 2:
Practice Address - City:NEWBURY PARK
Practice Address - State:CA
Practice Address - Zip Code:91320-2948
Practice Address - Country:US
Practice Address - Phone:805-768-5098
Practice Address - Fax:888-379-2687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-16
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility