Fides Assisted Living, Inc.

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

FIDES ASSISTED LIVING, INC.

Doing business as

Springfield Manor

Practice address

2526 New Ave
Rosemead, CA 91770-2939

Phone

(818) 846-4469

NPI assigned

Aug 26, 2022

Organization subpart

No

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

Authorized official

Name

Ted Bonzon, LCSW

Title

Licensee

Phone

(818) 846-4469

Specialties & licenses 1

Addresses

Other names 1

• Springfield Manor Doing business as

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

{
    "created_epoch": "1661472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672012800000",
    "number": "1558080044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2526 NEW AVE",
            "city": "ROSEMEAD",
            "state": "CA",
            "postal_code": "917702939",
            "telephone_number": "818-846-4469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2526 NEW AVE",
            "city": "ROSEMEAD",
            "state": "CA",
            "postal_code": "917702939",
            "telephone_number": "818-846-4469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIDES ASSISTED LIVING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-26",
        "last_updated": "2022-12-26",
        "certification_date": "2022-12-26",
        "status": "A",
        "authorized_official_last_name": "BONZON",
        "authorized_official_first_name": "TED",
        "authorized_official_title_or_position": "LICENSEE",
        "authorized_official_telephone_number": "818-846-4469",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Springfield Manor",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Springfield Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Hoa Nguyen Faust, LICENSED MFT
• Isaiah Tajour Feil-Sharp
• Xin Feng
• Jennifer Christine Fennessy, RN
• Patricia Ferrera-Anthony
• Jazmin Figueroa Hernandez
• Margarita Teresa Fimbrez
• First Unlimited Hospice Care, Inc.
• Firstsight Vision Services, Inc.
• Kaiya Joi Fisher

• Mental Illness Community Based Residential Treatment Facility in Rosemead, CA
• Providers in Rosemead, CA by specialty
• Mental Illness Community Based Residential Treatment Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 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.