Organization Active NPI

Congregational Homes

Doing business as Mt San Antonio Gardens

  • Skilled Nursing Facility
  • Pomona, CA
National Provider Identifier
1609859461
Registry record updated Jul 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
950000078 Issued in CA
Legal business name
CONGREGATIONAL HOMES
Doing business as
Mt San Antonio Gardens
Practice address
900 E Harrison Ave
Pomona, CA 91767-2075
Phone
(909) 624-5061
Fax
(909) 626-2126
NPI assigned
Nov 25, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2016

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

Authorized official

Name
Ms. Patricia Williams, C.F.O.
Title
C.F.O.
Phone
(909) 399-1281

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 191500496 CA
Skilled Nursing Facility 314000000X 950000078 CA Primary

Addresses

Primary practice location

900 E Harrison Ave
Pomona, CA 91767-2075

Mailing address

900 E Harrison Ave
Pomona, CA 91767-2075
Phone (909) 624-5061

Other names 1

  • MT SAN ANTONIO GARDENS Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20070731000152 CA Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 6901907245 Practice locations: Pomona, CA
O20070801000156 CA Part A Provider - Skilled Nursing Facility 6901907245 Practice locations: Pomona, CA
O20171122001744 CA Part B Supplier - Clinic/Group Practice 6901907245 Receives reassigned benefits from 3 practitioners
Practice locations: Pomona, CA

Skilled nursing facility certification: CCN 055016

Legal name
CONGREGATIONAL HOMES
Doing business as
MT SAN ANTONIO GARDENS
Certification status
Active
Provider type (POS)
Nursing home – SNF (Medicare) only
Participating since
Jan 1, 1967
Last certification
May 30, 2025
Beds
64
Ownership / control type
Nonprofit Corporation
Organization structure
CorporationNon-profit
Incorporated
May 8, 1957 in CA
Enrollment address
900 E Harrison Ave
Pomona, CA 91767-2075
Nursing home name
MOUNT SAN ANTONIO GARDENS

Outpatient physical therapy / speech pathology certification: CCN 556516

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
MT SAN ANTONIO GARDENS
Certification status
Active
Provider type (POS)
Outpatient physical therapy / speech pathology
Participating since
Oct 7, 1999
Last certification
Sep 15, 2023
Ownership / control type
Voluntary Non-Profit Other Than Church
Facility address
900 East Harrison Avenue, Suite 103
Pomona, CA 91767

Care Compare: Nursing home

Medicare Care Compare
Listed as
Mount San Antonio GardensCCN 055016 · All quality measures
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
3 of 5
Quality measures
5 of 5
Type
Medicare
Ownership
Non profit - Corporation
Certified
Jan 1, 1967
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
6440.2 residents per day on average

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0564291Mt San Antonio Gardens900 E Harrison Ave, Pomona, CA 91767Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 34

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Diane K Stielstra Individual Corporate DirectorBoard Member Jan 6, 2022
Operational/Managerial Control Jan 6, 2022
Adp of the SNF Jan 6, 2022
Evelyn D Brown Individual Corporate DirectorBoard Member Jan 6, 2022
Operational/Managerial Control Jan 6, 2022
Adp of the SNF Jan 1, 2021
Camille Lee Individual Corporate DirectorBoard Member Jan 1, 2025
Operational/Managerial Control Jan 1, 2025
Adp of the SNF Jan 1, 2023
John R Whiting Individual Corporate DirectorBoard Member Jan 1, 2022
Operational/Managerial Control Jan 1, 2022
Adp of the SNF Jan 1, 2022
Kathy Pezdek Individual Corporate DirectorBoard Member Jan 1, 2022
Operational/Managerial Control Jan 1, 2022
Adp of the SNF Jan 1, 2022
Nicole Weekes Individual Corporate DirectorBoard Member Jan 1, 2024
Operational/Managerial Control Jan 1, 2024
Adp of the SNF Jan 1, 2024
Michelle L Stoddard Individual Corporate DirectorBoard Member Jan 1, 2023
Operational/Managerial Control Jan 1, 2023
Adp of the SNF Jan 1, 2023
Leslie J Negritto Individual Corporate DirectorBoard Member Jan 23, 2020
Operational/Managerial Control Jan 23, 2020
Adp of the SNF Jan 23, 2020
Ryan R Zimmerman Individual Corporate DirectorBoard Member Jan 7, 2021
Operational/Managerial Control Jan 7, 2021
Adp of the SNF Jan 7, 2021
Robert Marriott Medical Corp Organization, El Segundo, CA Consulting firm, For-profit Limited Partnership Interest Jan 1, 2024 100%
Operational/Managerial Control Jan 1, 2024
Adp of the SNF Dec 18, 2025
Jeffrey K Stark Individual Corporate DirectorBoard Member Jan 6, 2018
Operational/Managerial Control Jan 6, 2018
Adp of the SNF Jan 6, 2018
Lisa Atilano Individual Corporate OfficerCoo Jul 25, 2024
Operational/Managerial Control Jul 25, 2024
Adp of the SNF Jul 25, 2024
Rachelle M Murphy Individual Corporate DirectorBoard Member Jan 1, 2023
Operational/Managerial Control Jan 1, 2023
Adp of the SNF Jan 1, 2023
Mary Ann Quay Individual Corporate DirectorBoard Member Jan 1, 2021
Operational/Managerial Control Jan 1, 2021
Adp of the SNF Jan 1, 2021
William Wells Individual Corporate DirectorBoard Member Jan 1, 2024
Operational/Managerial Control Jan 1, 2024
Adp of the SNF Jan 1, 2024
Robin J Aspinall Individual Corporate DirectorBoard Member Jan 1, 2023
Operational/Managerial Control Jan 1, 2023
Adp of the SNF Jan 1, 2023
Wipfli LLP Organization, Milwaukee, WI Consulting firm, For-profit Operational/Managerial Control Jan 1, 2025
Adp of the SNF Jan 1, 2025
Daljinder S Takhar Individual Corporate DirectorMedical Director Jan 1, 2022
Operational/Managerial Control Jan 1, 2022
Adp of the SNF Jan 1, 2022
Michael S Strange Individual Corporate DirectorBoard Member Jan 1, 2023
Operational/Managerial Control Jan 1, 2023
Adp of the SNF Jan 1, 2023
Michael L Vestino Individual Corporate DirectorBoard Member Jan 6, 2022
Operational/Managerial Control Jan 6, 2022
Adp of the SNF Jan 6, 2022
Jan Bush Individual Corporate DirectorBoard Member Jan 1, 2023
Operational/Managerial Control Jan 1, 2023
Adp of the SNF Jan 1, 2023
Eleanor P Brown Individual Corporate DirectorBoard Member Jan 1, 2021
Operational/Managerial Control Jan 1, 2021
Adp of the SNF Jan 1, 2021
David J Menefee Libey Individual Corporate DirectorBoard Member Jan 1, 2021
Operational/Managerial Control Jan 1, 2021
Adp of the SNF Jan 1, 2021
Lina Dina Individual Operational/Managerial Control Sep 13, 2021
Adp of the SNF Sep 13, 2021
Congregational Homes Organization, Pomona, CA Created for acquisition, Non-profit 5% Or Greater Direct Ownership Interest Jun 9, 2007 100%
Operational/Managerial Control Jun 9, 2007
Patricia L Williams Individual Corporate OfficerCeo Jan 20, 2015
Operational/Managerial Control Jan 20, 2015
Adp of the SNF Jan 20, 2015
Daryl G Smith Individual Corporate DirectorBoard Member Jan 6, 2022
Operational/Managerial Control Jan 6, 2022
Adp of the SNF Jan 6, 2022
Lise Abrams Individual Corporate DirectorBoard Member Jan 1, 2023
Operational/Managerial Control Jan 1, 2023
Adp of the SNF Jan 1, 2023
Mary Jean Neault Individual Corporate DirectorBoard Member Jan 1, 2023
Operational/Managerial Control Jan 1, 2023
Adp of the SNF Jan 1, 2023
John C Harpole Individual Corporate DirectorBoard Member Jan 1, 2021
Operational/Managerial Control Jan 1, 2021
Adp of the SNF Jan 1, 2021
Neil B Gerard Individual Corporate DirectorBoard Member Jan 1, 2023
Operational/Managerial Control Jan 1, 2023
Adp of the SNF Jan 1, 2023
Rolando F Cuaresma Individual Operational/Managerial Control Feb 3, 2025
Adp of the SNF Feb 3, 2025
Citrus Pharmacy Organization, Redlands, CA Medical provider/supplier, Consulting firm Limited Partnership Interest Aug 1, 2025 100%
Operational/Managerial Control Aug 1, 2025
Adp of the SNF Jan 1, 2025
Jill Grigsby Individual Corporate DirectorBoard Member Jan 1, 2023
Operational/Managerial Control Jan 1, 2023
Adp of the SNF Jan 1, 2023

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 65

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 65

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 20

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1132876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468972800000",
    "number": "1609859461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 E HARRISON AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917672075",
            "telephone_number": "909-624-5061",
            "fax_number": "909-626-2126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 E HARRISON AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917672075",
            "telephone_number": "909-624-5061",
            "fax_number": "909-626-2126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONGREGATIONAL HOMES",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-25",
        "last_updated": "2016-07-20",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "C.F.O.",
        "authorized_official_telephone_number": "909-399-1281",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "C.F.O."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CA",
            "license": "191500496",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "950000078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MT SAN ANTONIO GARDENS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pomona, CA

Sources for this page

Verify at the official NPI Registry.