La Fuente Lavender LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

361800009 Issued in CA

Legal business name

LA FUENTE LAVENDER LLC

Practice address

9545 Tamarind Ave
Fontana, CA 92335-5962

Phone

(909) 346-0292

Fax

(909) 346-0292

NPI assigned

Aug 9, 2016

Last updated

Aug 9, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Sotero Chandler Ramas III

Title

President/Ceo

Phone

(909) 346-0292

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1470700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470700800000",
    "number": "1093269946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9545 TAMARIND AVE",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923355962",
            "telephone_number": "909-346-0292",
            "fax_number": "909-346-0292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9545 TAMARIND AVE",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923355962",
            "telephone_number": "909-346-0292",
            "fax_number": "909-346-0292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA FUENTE LAVENDER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-09",
        "last_updated": "2016-08-09",
        "status": "A",
        "authorized_official_last_name": "RAMAS",
        "authorized_official_first_name": "SOTERO",
        "authorized_official_middle_name": "CHANDLER",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "909-346-0292",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CA",
            "license": "361800009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RESIDENTIAL CARE FOR ELDERLY LICENSE NUMBER",
            "identifier": "361800009",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Fontana, CA
• Providers in Fontana, CA by specialty
• Assisted Living Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2016; 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.