Unified Care Congregate Living, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

UNIFIED CARE CONGREGATE LIVING, LLC

Practice address

13668 Darwin Dr
Moreno Valley, CA 92555-2554

Phone

(714) 623-0859

NPI assigned

Dec 27, 2024

Last updated

Dec 30, 2024By 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

Mr. Adam De Los Reyes, RN

Title

Administrator/ Don

Phone

(714) 623-0859

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1735257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735516800000",
    "number": "1548078132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16909 SIMONDS ST",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913443619",
            "telephone_number": "714-623-0859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13668 DARWIN DR",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925552554",
            "telephone_number": "714-623-0859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIFIED CARE CONGREGATE LIVING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-27",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A",
        "authorized_official_last_name": "DE LOS REYES",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "ADMINISTRATOR/ DON",
        "authorized_official_telephone_number": "714-623-0859",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2024; 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.