Fairmont Healthcare Corp.

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

Legal business name

FAIRMONT HEALTHCARE CORP.

Practice address

13907 E. Amar Rd
Unit D
La Puente, CA 91746-1676

Phone

(626) 338-4606

NPI assigned

Dec 15, 2006

Organization subpart

No

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

Authorized official

Name

Shirley S Devera

Title

Cfo

Phone

(626) 338-4606

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Casa Del Sol Adult Day Health Care Center Doing business as

Locations

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013079177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13907 AMAR RD",
            "address_2": "UNIT D",
            "city": "LA PUENTE",
            "state": "CA",
            "postal_code": "917461676",
            "telephone_number": "626-338-4606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13907 E. AMAR RD",
            "address_2": "UNIT D",
            "city": "LA PUENTE",
            "state": "CA",
            "postal_code": "917461676",
            "telephone_number": "626-338-4606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRMONT HEALTHCARE CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DEVERA",
        "authorized_official_first_name": "SHIRLEY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "626-338-4606"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NUMBER",
            "identifier": "ADU70167G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Casa Del Sol Adult Day Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Adult Day Care Clinic/Center in La Puente, CA
• Providers in La Puente, CA by specialty
• Adult Day Care Clinic/Center in California

• 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.