Pacifica Monte Vista LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

PACIFICA MONTE VISTA LLC

Practice address

2211 Massachusetts Ave
Lemon Grove, CA 91945-3616

Phone

(619) 465-1331

NPI assigned

Apr 5, 2024

Organization subpart

No

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

Authorized official

Name

Deepak Israni

Title

General Manager

Phone

(619) 296-9000

Specialties & licenses 1

Addresses

Other names 1

• Monte Vista Village Senior Living Doing business as

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

{
    "created_epoch": "1712275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712275200000",
    "number": "1609628130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2211 MASSACHUSETTS AVE",
            "city": "LEMON GROVE",
            "state": "CA",
            "postal_code": "919453616",
            "telephone_number": "619-465-1331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 MASSACHUSETTS AVE",
            "city": "LEMON GROVE",
            "state": "CA",
            "postal_code": "919453616",
            "telephone_number": "619-465-1331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFICA MONTE VISTA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-05",
        "last_updated": "2024-04-05",
        "certification_date": "2024-04-05",
        "status": "A",
        "authorized_official_last_name": "ISRANI",
        "authorized_official_first_name": "DEEPAK",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "619-296-9000"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Monte Vista Village Senior Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Lemon Grove, CA
• Providers in Lemon Grove, CA by specialty
• Assisted Living Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 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.