Monarch Home

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

License

LTC80409F Issued in CA

Legal business name

MONARCH HOME

Practice address

411 Dennis Dr
Vista, CA 92083-7776

Phone

(760) 842-5147

Fax

(760) 842-5148

NPI assigned

Feb 6, 2008

Organization subpart

No

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

Authorized official

Name

Herminio Fernandez Deleon

Title

Owner

Phone

(760) 842-5147

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1202256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202256000000",
    "number": "1760660336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 DENNIS DR",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920837776",
            "telephone_number": "760-842-5147",
            "fax_number": "760-842-5148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 DENNIS DR",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920837776",
            "telephone_number": "760-842-5147",
            "fax_number": "760-842-5148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONARCH HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-06",
        "last_updated": "2008-02-06",
        "status": "A",
        "authorized_official_last_name": "DELEON",
        "authorized_official_first_name": "HERMINIO",
        "authorized_official_middle_name": "FERNANDEZ",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "760-842-5147"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "CA",
            "license": "LTC80409F",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC80409F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Intellectual Disabilities Intermediate Care Facility in Vista, CA
• Providers in Vista, CA by specialty
• Intellectual Disabilities Intermediate Care Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2008; 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.