Villa Redondo Care Home Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

198204399 Issued in CA

Legal business name

VILLA REDONDO CARE HOME INC

Practice address

237 Redondo Ave
Long Beach, CA 90803-5951

Phone

(562) 434-9931

NPI assigned

Oct 10, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Michael Talavera Bolong

Title

Officer

Phone

(562) 434-9932

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1381363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381363200000",
    "number": "1346677192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "237 REDONDO AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908035951",
            "telephone_number": "562-434-9931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "237 REDONDO AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908035951",
            "telephone_number": "562-434-9931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLA REDONDO CARE HOME INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-10",
        "last_updated": "2013-10-10",
        "status": "A",
        "authorized_official_last_name": "BOLONG",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "TALAVERA",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "562-434-9932",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CA",
            "license": "198204399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Long Beach, CA
• Providers in Long Beach, 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 Oct 10, 2013; 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.