Provider Demographics
NPI:1932231370
Name:HENRY MAYO NEWHALL MEM HOSP SNF
Entity Type:Organization
Organization Name:HENRY MAYO NEWHALL MEM HOSP SNF
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND C.E.O.
Authorized Official - Prefix:MR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:E
Authorized Official - Last Name:SEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-253-8000
Mailing Address - Street 1:23845 MCBEAN PKWY
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-2001
Mailing Address - Country:US
Mailing Address - Phone:661-253-8000
Mailing Address - Fax:661-253-8142
Practice Address - Street 1:23845 MCBEAN PKWY
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-2001
Practice Address - Country:US
Practice Address - Phone:661-253-8000
Practice Address - Fax:661-253-8142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALTC55422FMedicaid
CA555422Medicare Oscar/Certification