KP Healthcare - Dba Lotus Villa Memory Care

Primary specialty

Assisted Living Facility (Behavioral Disturbances)Taxonomy code 3104A0630X

Legal business name

KP HEALTHCARE - DBA LOTUS VILLA MEMORY CARE

Doing business as

Lotus Villa & Memory Care

Practice address

9448 Citrus Ave
Fontana, CA 92335-5512

Phone

(909) 355-6887

Fax

(909) 355-6882

NPI assigned

Dec 26, 2019

Organization subpart

No

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

Authorized official

Name

Felisa N Day

Title

Administrator

Phone

(909) 355-6887

Specialties & licenses 2

Addresses

Other names 1

• LOTUS VILLA & MEMORY CARE Doing business as

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

{
    "created_epoch": "1577318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581033600000",
    "number": "1780223503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9448 CITRUS AVE",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923355512",
            "telephone_number": "909-355-6887",
            "fax_number": "909-355-6882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9448 CITRUS AVE",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923355512",
            "telephone_number": "909-355-6887",
            "fax_number": "909-355-6882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KP HEALTHCARE - DBA LOTUS VILLA MEMORY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-26",
        "last_updated": "2020-02-07",
        "certification_date": "2020-02-07",
        "status": "A",
        "authorized_official_last_name": "DAY",
        "authorized_official_first_name": "FELISA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "909-355-6887"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3104A0630X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LOTUS VILLA & MEMORY CARE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "LOTUS VILLA & MEMORY CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mostafa Koperly
• Thoyaja Koritala, M.D.
• Thelma Z. Korpman, MD
• Bruce R. Koyle, DO
• Maher S. Kozman, MD
• Puiling Kraft, PHARM.D.
• Edita Krakora, M.D.
• Lewis L. Kramer, MD
• Jamie L Krantzberg, PA
• Sin S. Ku, MD

• Assisted Living Facility (Behavioral Disturbances) in Fontana, CA
• Providers in Fontana, CA by specialty
• Assisted Living Facility (Behavioral Disturbances) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2020; 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.