Premiercare 2 Congregate Living, Inc.

Primary specialty

Assisted Living Facility (Behavioral Disturbances)Taxonomy code 3104A0630X

Legal business name

PREMIERCARE 2 CONGREGATE LIVING, INC.

Practice address

9349 Rose St
Bellflower, CA 90706-6423

Phone

(818) 642-3668

NPI assigned

Oct 22, 2015

Organization subpart

No

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

Authorized official

Name

Mrs. Marilyn V Nguyen, RN

Title

Pres/Administrator/DPCS

Phone

(805) 210-2194

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1445472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613952000000",
    "number": "1124490792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4805 LEEDS ST",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930633051",
            "telephone_number": "805-210-2194",
            "fax_number": "805-210-2258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9349 ROSE ST",
            "city": "BELLFLOWER",
            "state": "CA",
            "postal_code": "907066423",
            "telephone_number": "818-642-3668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIERCARE 2 CONGREGATE LIVING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-22",
        "last_updated": "2021-02-22",
        "certification_date": "2021-02-22",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PRES/ADMINISTRATOR/DPCS",
        "authorized_official_telephone_number": "805-210-2194",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "3104A0630X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primecare Bellflower LLC
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• Emmy Puente, RDA
• Tania Puentes

• Assisted Living Facility (Behavioral Disturbances) in Bellflower, CA
• Providers in Bellflower, CA by specialty
• Assisted Living Facility (Behavioral Disturbances) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2021; 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.