Active NPI
Lita & Ava Inc.
- Skilled Nursing Facility
- San Jose, CA
National Provider Identifier
1689828840
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- LITA & AVA INC.
- Practice address
- 1250 S Winchester Blvd
San Jose, CA 95128-3906 - Phone
- (408) 241-3844
- Fax
- (408) 241-6430
- NPI assigned
- Nov 13, 2008
- 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
- Julita A Javier
- Title
- President
- Phone
- (408) 241-3844
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
1250 S Winchester Blvd
San Jose, CA 95128-3906
Mailing address
1250 S Winchester Blvd
San Jose, CA 95128-3906
Phone (408) 241-3844
Other names 1
- A Grace Sub Acute & Skilled Care
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090218000677 | CA | Part A Provider - Skilled Nursing Facility | 0648335034 | Practice locations: San Jose, CA |
Skilled nursing facility certification: CCN 056376
- Legal name
- LITA & AVA INC.
- Doing business as
- A GRACE SUB ACUTE & SKILLED CARE
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jul 1, 1980
- Last certification
- Oct 18, 2024
- Beds
- 166
- Ownership / control type
- Corporation
- Most recent change of ownership
- Nov 1, 2008
- Organization structure
- Corporation
- Incorporated
- Sep 18, 2008 in CA
- Enrollment address
- 1250 S Winchester Blvd
San Jose, CA 95128-3906 - Nursing home name
- A GRACE SUB ACUTE & SKILLED CARE
Care Compare: Nursing home
Medicare Care Compare- Listed as
- A Grace Sub Acute & Skilled Care
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Jul 1, 1980
- Medicare certification status
- Active
- Certified beds
- 166
National Provider Directory
National Provider Directory- Tax ID family
- Lita Ava Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Skilled Nursing Facility
- San Jose, CA
- NPI 1962648626
Ownership & related parties
All disclosed owners & managing parties 6
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Pelita Sanchez | Corporate Director | Dec 15, 2008 | |
| James Rando | 5% Or Greater Direct Ownership Interest | Dec 15, 2008 | |
| Julita a Javier | 5% Or Greater Direct Ownership Interest | Dec 15, 2008 | |
| Pepito M Javier | 5% Or Greater Direct Ownership Interest | Dec 15, 2008 | |
| Corporate Director | Dec 15, 2008 | ||
| Jason S Adelman | 5% Or Greater Direct Ownership Interest | Dec 15, 2008 | |
| Victor Aquino | W-2 Managing Employee | Apr 16, 2014 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Hospitalist Physician
- New York, NY
- NPI 1114129400
5% Or Greater Direct Ownership Interest
Subparts reporting this organization as parent 1
Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.
-
- Skilled Nursing Facility
- San Jose, CA
- NPI 1962648626
Practitioners & affiliated clinicians
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": "1226534400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1397520000000",
"number": "1689828840",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1250 S WINCHESTER BLVD",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951283906",
"telephone_number": "408-241-3844",
"fax_number": "408-241-6430"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1250 S WINCHESTER BLVD",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951283906",
"telephone_number": "408-241-3844",
"fax_number": "408-241-6430"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LITA & AVA INC.",
"organizational_subpart": "NO",
"enumeration_date": "2008-11-13",
"last_updated": "2014-04-15",
"status": "A",
"authorized_official_last_name": "JAVIER",
"authorized_official_first_name": "JULITA",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "408-241-3844"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "A Grace Sub Acute & Skilled Care",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2014; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.