NPIMap

Organization Active NPI

Our Lady of Mercy Home 2

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • West Covina, CA
National Provider Identifier
1508131491
Registry record updated Mar 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
Legal business name
OUR LADY OF MERCY HOME 2
Practice address
3845 S Morganfield Ave
West Covina, CA 91792-3238
Phone
(909) 444-5796
Fax
(909) 594-3604
NPI assigned
Mar 12, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2012

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

Authorized official

Name
Mrs. Lydia S Debastian, RN
Title
Owner/Licencee
Phone
(909) 578-5453

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X CA Primary

Addresses

Primary practice location

3845 S Morganfield Ave
West Covina, CA 91792-3238

Mailing address

3845 S Morganfield Ave
West Covina, CA 91792-3238
Phone (909) 444-5796

National Provider Directory

National Provider Directory
Tax ID family
Our Lady of Mercy Home3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1331510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331510400000",
    "number": "1508131491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3845 S MORGANFIELD AVE",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917923238",
            "telephone_number": "909-444-5796",
            "fax_number": "909-594-3604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3845 S MORGANFIELD AVE",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917923238",
            "telephone_number": "909-444-5796",
            "fax_number": "909-594-3604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUR LADY OF MERCY HOME 2",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-12",
        "last_updated": "2012-03-12",
        "status": "A",
        "authorized_official_last_name": "DEBASTIAN",
        "authorized_official_first_name": "LYDIA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER/LICENCEE",
        "authorized_official_telephone_number": "909-578-5453",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2012; 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.