NPIMap

Organization Active NPI

F.C.H. Inc.

  • Skilled Nursing Facility
  • Santa Monica, CA
National Provider Identifier
1679558175
Registry record updated Apr 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
910000048 Issued in CA
Legal business name
F.C.H. INC.
Practice address
947 3Rd St
Santa Monica, CA 90403-2599
Phone
(310) 393-0475
NPI assigned
Dec 7, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2024

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

Authorized official

Name
Marc Johnson
Title
Cfo
Phone
(949) 373-8373

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 910000048 CA Primary

Addresses

Primary practice location

947 3Rd St
Santa Monica, CA 90403-2599

Mailing address

25910 Acero Ste 350
Mission Viejo, CA 92691-7908
Phone (949) 441-9258

Other identifiers 1

IdentifierTypeStateIssuer
ZZT18108GMedicaidCA

Other names 1

  • FIRESIDE CONVALESCENT HOSPITAL Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111220000205 CA Part A Provider - Skilled Nursing Facility 9133249600 Practice locations: Santa Monica, CA

Skilled nursing facility certification: CCN 555039

Legal name
F.C.H., INC.
Doing business as
FIRESIDE HEALTH CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 1, 1977
Last certification
Dec 1, 2024
Beds
66
Ownership / control type
Corporation
Organization structure
CorporationProprietary
Incorporated
Mar 16, 2006 in NV
Enrollment address
947 3Rd St
Santa Monica, CA 90403-2508
Nursing home name
FIRESIDE HEALTH CARE CENTER
Affiliated entity
NAHS

Care Compare: Nursing home

Medicare Care Compare
Listed as
Fireside Health Care CenterCCN 555039
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
3 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jan 1, 1977
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
6661.3 residents per day on average
Chain
Nahs12 facilities in the chain
Penalties (3 years)
2Fines totaling $97,670

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
05D0549856Fireside Convalescent Hospital947 3Rd St, Santa Monica, CA 90403Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Organization, Los Angeles, CA LLC Adp of the SNF Jan 1, 2024
Damon Bradley Raskin Individual Operational/Managerial Control Jan 1, 2012
Adp of the SNF Aug 27, 2025
Mark Walton Individual Corporate OfficerSecretary Jun 29, 2018
Corporate DirectorSecretary Jun 29, 2018
Heidi G Alipio Individual Corporate OfficerPresident/Administrator Aug 5, 2025
Corporate DirectorPresident/Administrator Aug 5, 2025
Operational/Managerial Control Aug 5, 2025
Managing Control - Governing BodyCorporate Director Aug 5, 2025
Adp of the SNF Aug 5, 2025
James Barlow Individual Corporate DirectorDirector Jun 29, 2018
Timothy J Paulsen Individual Corporate DirectorChairperson of the Board Jun 29, 2018
Michael J Moore Individual Corporate OfficerCeo/President Feb 1, 2022
Corporate DirectorCeo/President Feb 1, 2022
Nahs Holding Inc Organization, Mission Viejo, CA Corporation, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jun 30, 2018
James Ellis-Sherinian Individual Corporate DirectorDirector Oct 1, 2020
Managing Control - Governing BodyDirector Oct 1, 2020
Victor G Lundquist Individual Corporate OfficerSecretary Mar 21, 2018
Organization, Mission Viejo, CA Indirect Ownership Interest Jun 30, 2018
Nahs Southwest Inc Organization, Mission Viejo, CA Corporation, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jun 30, 2018
Direct Ownership Interest Jun 30, 2018
Marc Johnson Individual Corporate OfficerTreasurer Nov 20, 2022
Adp of the SNF Nov 20, 2022
Ralph Baja Individual Corporate DirectorDirector Jul 1, 2023

Owners & managing parties with NPI records 1

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

Facilities with the same owner 11

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

Practitioners & affiliated clinicians

Affiliated clinicians 7

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": "1133913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712275200000",
    "number": "1679558175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25910 ACERO STE 350",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926917908",
            "telephone_number": "949-441-9258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "947 3RD ST",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904032599",
            "telephone_number": "310-393-0475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "F.C.H. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-07",
        "last_updated": "2024-04-05",
        "certification_date": "2024-04-05",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "MARC",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "949-373-8373"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "910000048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT18108G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FIRESIDE CONVALESCENT HOSPITAL",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "FIRESIDE CONVALESCENT HOSPITAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.