Eon Resources Corp

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

Legal business name

EON RESOURCES CORP

Doing business as

LA VERNE MANOR

Practice address

2555 6TH St
La Verne, CA 91750-4617

Phone

(909) 593-4567

Fax

(909) 971-3108

NPI assigned

Jul 22, 2021

Organization subpart

No

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

Authorized official

Name

John Michael Tanada

Title

Administrator

Phone

(909) 593-4567

Specialties & licenses 1

Addresses

Other names 1

• LA VERNE MANOR Doing business as

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

{
    "created_epoch": "1626912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626912000000",
    "number": "1740853118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 987",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917500987",
            "telephone_number": "909-593-4567",
            "fax_number": "909-971-3108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2555 6TH ST",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917504617",
            "telephone_number": "909-593-4567",
            "fax_number": "909-971-3108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EON RESOURCES CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-22",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-22",
        "status": "A",
        "authorized_official_last_name": "TANADA",
        "authorized_official_first_name": "JOHN MICHAEL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "909-593-4567"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LA VERNE MANOR",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sheena Edmonds, MS, LMFT
• Craig Yoshio Endo, M.D.
• Tiffany P. Le Endo, D.O.
• Joanna Rachel Engel, ATC
• Entech Medical Corporation
• Manuel Antonio Escalante Jr., ATC
• Marissa Selina Esquibel
• Melanie Estrada
• Andrew Eusebio Jr.
• Lauren Marie Evans, LMFT

• Assisted Living Facility (Mental Illness) in La Verne, CA
• Providers in La Verne, CA by specialty
• Assisted Living Facility (Mental Illness) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.