Organization Active NPI

Riverside Care, Inc.

  • Skilled Nursing Facility
  • Riverside, CA
National Provider Identifier
1689062838
Registry record updated Apr 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
RIVERSIDE CARE, INC.
Practice address
4301 Caroline CT
Riverside, CA 92506-2902
Phone
(951) 683-7111
NPI assigned
Dec 22, 2014
Last updated
Apr 5, 2024By the provider in NPPES
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 Primary

Addresses

Primary practice location

4301 Caroline CT
Riverside, CA 92506-2902

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
ZZT05584GMedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150925001085 CA Part A Provider - Skilled Nursing Facility 0749506947 Practice locations: Riverside, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1689062838. Details of each certification follow.

Skilled nursing facility certification: CCN 555331

Legal name
RIVERSIDE CARE INC
Doing business as
VALENCIA GARDENS HEALTH CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Oct 28, 1988
Last certification
Jun 6, 2024
Beds
59 (50 certified)
Ownership / control type
Corporation
Multi-facility organization
North American Client Services
Organization structure
CorporationProprietary
Incorporated
Oct 13, 2014 in NV
Enrollment address
4301 Caroline CT
Riverside, CA 92506-2902
Nursing home name
VALENCIA GARDENS HEALTH CARE CENTER
Affiliated entity
NAHS

Care Compare: Nursing home

Medicare Care Compare
Listed as
Valencia Gardens Health Care CenterCCN 555331 · All quality measures
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
3 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Oct 28, 1988
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
5053.9 residents per day on average
Chain
Nahs12 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Locations

4301 Caroline Ct
Riverside, CA 92506
Phone (909) 973-7772

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Nahs Employee Stock Ownership Trust Organization, Mission Viejo, CA 5% Or Greater Indirect Ownership Interest Jun 30, 2018 100%
Nahs Southeast, Inc. Organization, Mission Viejo, CA Corporation, Holding company, For-profit 5% Or Greater Direct Ownership Interest Jun 30, 2018 100%
Brenden Q Dahl Individual Corporate Director Feb 1, 2023
Nahs Holding Inc Organization, Mission Viejo, CA Corporation, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Jun 30, 2018 100%
James Ellis-Sherinian Individual Corporate Director Oct 1, 2020
Franklin Hughes Individual Corporate Officer Aug 15, 2023
Corporate Director Aug 15, 2023
W-2 Managing Employee Aug 15, 2023
Operational/Managerial Control Aug 15, 2023
Victor G Lundquist Individual Corporate OfficerSecretary Mar 21, 2018
Marc Johnson Individual Corporate OfficerCfo Nov 20, 2022

Facilities with the same owner 10

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

Practitioners & affiliated clinicians

Affiliated clinicians 4

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": "1419206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712275200000",
    "number": "1689062838",
    "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",
            "fax_number": "951-683-6826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 CAROLINE CT",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925062902",
            "telephone_number": "951-683-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-22",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT05584G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.