NPIMap

Organization Active NPI

Gardena House

  • Intellectual Disabilities Intermediate Care Facility
  • Rialto, CA
National Provider Identifier
1013032606
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
GARDENA HOUSE
Practice address
1041 N Gardena Ave
Rialto, CA 92376-4214
Phone
(909) 874-7690
Fax
(909) 874-8689
NPI assigned
Mar 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Cheryl B Jumonville
Title
Exec Vice President
Phone
(951) 682-4833

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X Primary

Addresses

Primary practice location

1041 N Gardena Ave
Rialto, CA 92376-4214

Mailing address

3674 Pacific Ave
Riverside, CA 92509-1948
Phone (951) 682-4833

Other names 1

  • VISTA PACIFICA ENTERPRISES,INC Other name

National Provider Directory

National Provider Directory
Tax ID family
Eucalyptus House6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013032606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3674 PACIFIC AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925091948",
            "telephone_number": "951-682-4833",
            "fax_number": "951-682-1503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1041 N GARDENA AVE",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923764214",
            "telephone_number": "909-874-7690",
            "fax_number": "909-874-8689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARDENA HOUSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JUMONVILLE",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "EXEC VICE PRESIDENT",
        "authorized_official_telephone_number": "951-682-4833",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VISTA PACIFICA ENTERPRISES,INC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Rialto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.