Organization Active NPI

West Covina Care, Inc.

Doing business as Beacon Healthcare Center

  • Skilled Nursing Facility
  • West Covina, CA
National Provider Identifier
1245897446
Registry record updated Apr 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
WEST COVINA CARE, INC.
Doing business as
Beacon Healthcare Center
Practice address
919 N Sunset Ave
West Covina, CA 91790-1244
Phone
(626) 962-4489
Fax
(626) 869-0290
NPI assigned
May 22, 2019
Last updated
Apr 5, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2024

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

Authorized official

Name
Marc Johnson
Title
Cfo
Phone
(949) 373-8373

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

919 N Sunset Ave
West Covina, CA 91790-1244

Mailing address

25910 Acero Ste 350
Mission Viejo, CA 92691-7908
Phone (949) 441-9258

Other names 1

  • Beacon Healthcare Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190916003449 CA Part A Provider - Skilled Nursing Facility 6103155114 Practice locations: West Covina, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1245897446. Details of each certification follow.

Skilled nursing facility certification: CCN 056331

Legal name
WEST COVINA CARE INC
Doing business as
BEACON HEALTHCARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jun 1, 1976
Last certification
Nov 17, 2024
Beds
54
Ownership / control type
Corporation
Multi-facility organization
NAHS Southwest Inc.
Organization structure
CorporationProprietary
Enrollment address
919 N Sunset Ave
West Covina, CA 91790-1244
Nursing home name
BEACON HEALTHCARE CENTER
Affiliated entity
NAHS

Care Compare: Nursing home

Medicare Care Compare
Listed as
Beacon Healthcare CenterCCN 056331 · All quality measures
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
3 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jun 1, 1976
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
5439.9 residents per day on average
Chain
Nahs12 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Locations

32836 Pacific Coast Hwy
Ste 203
Dana Point, CA 92629

Ownership & related parties

All disclosed owners & managing parties 14

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Larry Lewis Individual Corporate OfficerPresident Nov 1, 2024
Corporate DirectorPresident Nov 1, 2024
Operational/Managerial Control Nov 1, 2024
Managing Control - Governing BodyDirector Nov 1, 2024
Adp of the SNF Nov 1, 2024
Nahs Employee Stock Ownership Trust Organization, Mission Viejo, CA 5% Or Greater Indirect Ownership Interest Jun 30, 2018 100%
Indirect Ownership Interest Jun 30, 2018 100%
Nahs Southeast, Inc. Organization, Mission Viejo, CA Corporation, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jun 30, 2018
Direct Ownership Interest Jun 30, 2018
Mark Walton Individual Corporate OfficerSecretary Apr 1, 2019
Corporate DirectorDirector Apr 1, 2019
James Barlow Individual Corporate DirectorDirector Apr 1, 2019
Organization, Laguna Beach, CA LLC Adp of the SNF Apr 1, 2019
Timothy J Paulsen Individual Corporate DirectorChairperson of the Board Jun 29, 2018
Michael J Moore Individual Corporate OfficerPresident Feb 1, 2022
Corporate DirectorDirector Feb 1, 2022
Brenden Q Dahl Individual Corporate DirectorDirector Feb 1, 2023
Managing Control - Governing BodyDirector Feb 1, 2023
Nahs Holding Inc Organization, Mission Viejo, CA Corporation, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Apr 1, 2019
Anil Gupta Individual Operational/Managerial Control Apr 1, 2019
Adp of the SNF Jul 16, 2025
Victor G Lundquist Individual Corporate OfficerSecretary Apr 1, 2019
Marc Johnson Individual Corporate OfficerTreasurer Nov 20, 2022
Adp of the SNF Nov 20, 2022
Ralph Baja Individual Corporate DirectorDirector Jul 1, 2023

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 10

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Affiliated clinicians 6

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1558483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712275200000",
    "number": "1245897446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25910 ACERO STE 350",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926917908",
            "telephone_number": "949-441-9258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 N SUNSET AVE",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917901244",
            "telephone_number": "626-962-4489",
            "fax_number": "626-869-0290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST COVINA CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-22",
        "last_updated": "2024-04-05",
        "certification_date": "2024-04-05",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "MARC",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "949-373-8373"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beacon Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Beacon Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Covina, CA

Sources for this page

Verify at the official NPI Registry.