Active NPI
Foothill Care Center II, LLC
- Adult Care Home Facility
- West Covina, CA
National Provider Identifier
1679794309
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Care Home Facility
- Legal business name
- FOOTHILL CARE CENTER II, LLC
- Practice address
- 1304 W Durness St
West Covina, CA 91790-4766 - Phone
- (626) 960-7273
- NPI assigned
- May 1, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Miss Eden De Asis Salceda
- Title
- Administrator
- Phone
- (626) 962-3274
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Care Home Facility | 311ZA0620X | CA | Primary |
Addresses
Primary practice location
1304 W Durness St
West Covina, CA 91790-4766
Mailing address
1758 Big Dalton Ave
Baldwin Park, CA 91706-5910
Phone (626) 962-3274
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LTC60760F | Medicaid | CA |
Other names 1
- Durness Home
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Intermediate care facility for individuals with intellectual disabilities certification: CCN 55G032
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
- DURNESS HOME
- Certification status
- Active
- Provider type (POS)
- Intermediate care facility for individuals with intellectual disabilities
- Participating since
- Nov 15, 1996
- Last certification
- May 21, 2025
- Beds
- 6
- Ownership / control type
- Private (proprietary)
- Facility address
- 1304 West Durness Street
West Covina, CA 91790
National Provider Directory
National Provider Directory- Tax ID family
- Foothill Care Center II LLC
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
-
- Adult Care Home Facility
- Covina, CA
- NPI 1710108436
-
- Adult Care Home Facility
- West Covina, CA
- NPI 1871715193
-
- Adult Care Home Facility
- Covina, CA
- NPI 1962624288
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177977600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1679794309",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1758 BIG DALTON AVE",
"city": "BALDWIN PARK",
"state": "CA",
"postal_code": "917065910",
"telephone_number": "626-962-3274",
"fax_number": "626-962-4424"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1304 W DURNESS ST",
"city": "WEST COVINA",
"state": "CA",
"postal_code": "917904766",
"telephone_number": "626-960-7273"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FOOTHILL CARE CENTER II, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2007-05-01",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "SALCEDA",
"authorized_official_first_name": "EDEN",
"authorized_official_middle_name": "DE ASIS",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "626-962-3274",
"authorized_official_name_prefix": "Miss"
},
"taxonomies": [
{
"code": "311ZA0620X",
"taxonomy_group": "",
"desc": "Custodial Care Facility, Adult Care Home",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "LTC60760F",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Durness Home",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in West Covina, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.