De Leon Country Maureen'S Home

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

Legal business name

DE LEON COUNTRY MAUREEN'S HOME

Practice address

3959 Walnut Ave
Chino, CA 91710-2148

Phone

(562) 900-8789

Fax

(562) 724-7244

NPI assigned

Jul 17, 2014

Organization subpart

No

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

Authorized official

Name

Catherine Marie Carothers, B.S.

Title

Owner

Phone

(562) 900-8789

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Intermediate care facility for individuals with intellectual disabilities certification: CCN 55G369

Legal name

COUNTRY MAUREEN'S HOME

Certification status

Active

Provider type (POS)

Intermediate care facility for individuals with intellectual disabilities

Participating since

Mar 14, 2001

Last certification

Mar 25, 2025

Beds

6

Ownership / control type

Private (proprietary)

Facility address

3959 Walnut Avenue
Chino, CA 91710

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

{
    "created_epoch": "1405555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405555200000",
    "number": "1457768848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5310 E HARCO ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908081922",
            "telephone_number": "562-900-8789",
            "fax_number": "562-724-7244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3959 WALNUT AVE",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917102148",
            "telephone_number": "562-900-8789",
            "fax_number": "562-724-7244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DE LEON COUNTRY MAUREEN'S HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-17",
        "last_updated": "2014-07-17",
        "status": "A",
        "authorized_official_last_name": "CAROTHERS",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "562-900-8789",
        "authorized_official_credential": "B.S."
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Turner
• Theresa Marie Darrington, PH.D.
• David G Song MD Inc
• Dana Day, DPM
• Leah Clarisse Dayrit
• De Leon Homes, Inc
• John Ryan Lopez De Rivera, PTA
• Deirdre Degenaar, CNM, WHNP
• James William Degroot, LCSW
• Harley Albert Deisem Jr., DDS

• Developmental Disabilities Clinic/Center in Chino, CA
• Providers in Chino, CA by specialty
• Developmental Disabilities Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.