Corona Congregate Care

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

CORONA CONGREGATE CARE

Practice address

7890 Vandewater St
Eastvale, CA 92880-5514

Phone

(951) 847-5476

NPI assigned

Apr 27, 2022

Last updated

Apr 27, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lesley Sihavong VannoyNPI 1902540602

Title

Owner/Ceo

Phone

(951) 847-5476

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lesley Sihavong Vannoy

  • Adult Care Home Facility
  • Eastvale, CA
  • NPI 1902540602
  Authorized official Same address or phone

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

{
    "created_epoch": "1651017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651017600000",
    "number": "1467197103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7056 ARCHIBALD AVE # 102-322",
            "city": "EASTVALE",
            "state": "CA",
            "postal_code": "928808713",
            "telephone_number": "951-847-5476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7890 VANDEWATER ST",
            "city": "EASTVALE",
            "state": "CA",
            "postal_code": "928805514",
            "telephone_number": "951-847-5476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORONA CONGREGATE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-27",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A",
        "authorized_official_last_name": "VANNOY",
        "authorized_official_first_name": "LESLEY",
        "authorized_official_middle_name": "SIHAVONG",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "951-847-5476"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in Eastvale, CA
• Providers in Eastvale, CA by specialty
• Skilled Nursing Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2022; 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.