Fountain Care Center, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

080000646 Issued in CA

Legal business name

FOUNTAIN CARE CENTER, LLC

Doing business as

Fountain Care Center

Practice address

1835 West la Veta Avenue
Orange, CA 92868

Phone

(714) 978-6800

Fax

(714) 978-2544

NPI assigned

Apr 10, 2006

Organization subpart

Yes

Parent organization

SUMMIT CARE LLCAs reported in NPPES

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

Authorized official

Name

Michael T. Berg

Title

Assistant Secretary

Phone

(505) 468-4752

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Fountain Care Center Doing business as

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453852800000",
    "number": "1093778128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1835 WEST LA VETA AVENUE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "92868",
            "telephone_number": "714-978-6800",
            "fax_number": "714-978-2544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1835 WEST LA VETA AVENUE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "92868",
            "telephone_number": "714-978-6800",
            "fax_number": "714-978-2544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNTAIN CARE CENTER, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUMMIT CARE LLC",
        "enumeration_date": "2006-04-10",
        "last_updated": "2016-01-27",
        "status": "A",
        "authorized_official_last_name": "BERG",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "505-468-4752"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "080000646",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC555259G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fountain Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Robin Foster
• Gianna Fote
• Peter Anthony Fotinakes, M.D.
• Christopher John Fotinos, DDS
• Founders Healthcare, LLC
• Fourth Optometric Care of California
• Rachel Foust, DPT, PT
• Aaron B Fowler, M.D.
• Glenn W Fowler, MD
• Kelley Elaine Fowler

• Skilled Nursing Facility in Orange, CA
• Providers in Orange, CA by specialty
• Skilled Nursing Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 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.