NPIMap

Organization Active NPI

Valley View Sanitarium & Rest Home

Doing business as Villa Amistad

  • Nursing Facility/Intermediate Care Facility
  • San Diego, CA
National Provider Identifier
1427274810
Registry record updated Aug 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
Legal business name
VALLEY VIEW SANITARIUM & REST HOME
Doing business as
Villa Amistad
Practice address
628 Omeara St
San Diego, CA 92114-6731
Phone
(619) 266-2812
Fax
(619) 266-2460
NPI assigned
Apr 17, 2007
Last updated
Aug 17, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2007

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

Authorized official

Name
Mrs. Juanita Rettinghaus
Title
Executive Director
Phone
(619) 267-8400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X CA Primary

Addresses

Primary practice location

628 Omeara St
San Diego, CA 92114-6731

Mailing address

PO Box 90
National City, CA 91951-0090
Phone (619) 267-8400

Other identifiers 1

IdentifierTypeStateIssuer
LTC80043FMedicaidCA

Other names 1

  • Villa Amistad Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1427274810. Details of each certification follow.

  • CCN 05G595 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 05G595

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
FRIENDSHIP VILLA AMISTAD
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Aug 12, 1992
Last certification
May 1, 2025
Beds
6
Ownership / control type
Private (proprietary)
Facility address
628 Omeara Street
San Diego, CA 92114

National Provider Directory

National Provider Directory
Tax ID family
Valley View Sanitarium Rest Home20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

Organizations that report the same tax identification number in the National Provider Directory.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187308800000",
    "number": "1427274810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 90",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919510090",
            "telephone_number": "619-267-8400",
            "fax_number": "619-267-0892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "628 OMEARA ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921146731",
            "telephone_number": "619-266-2812",
            "fax_number": "619-266-2460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY VIEW SANITARIUM & REST HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2007-08-17",
        "status": "A",
        "authorized_official_last_name": "RETTINGHAUS",
        "authorized_official_first_name": "JUANITA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "619-267-8400",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC80043F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Villa Amistad",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.