Organization Active NPI

Trinity Maria, Inc

Doing business as Villa Maria Care Center

  • Skilled Nursing Facility
  • Long Beach, CA
National Provider Identifier
1366538373
Registry record updated Aug 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
TRINITY MARIA, INC
Doing business as
Villa Maria Care Center
Practice address
723 E 9TH St
Long Beach, CA 90813-4611
Phone
(562) 437-2797
Fax
(562) 437-8688
NPI assigned
Oct 5, 2006
Last updated
Aug 21, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2007

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

Authorized official

Name
Randal D Kleis
Title
President
Phone
(425) 820-9750

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X CA Primary

Addresses

Primary practice location

723 E 9TH St
Long Beach, CA 90813-4611

Mailing address

723 E 9TH St
Long Beach, CA 90813-4611
Phone (562) 437-2797

Other identifiers 1

IdentifierTypeStateIssuer
LTC05329FMedicaidCA

Other names 1

  • Villa Maria Care Center Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187654400000",
    "number": "1366538373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "723 E 9TH ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908134611",
            "telephone_number": "562-437-2797",
            "fax_number": "562-437-8688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "723 E 9TH ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908134611",
            "telephone_number": "562-437-2797",
            "fax_number": "562-437-8688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY MARIA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-08-21",
        "status": "A",
        "authorized_official_last_name": "KLEIS",
        "authorized_official_first_name": "RANDAL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-820-9750"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC05329F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Villa Maria Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2007; 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.