Organization Active NPI

Mountain View Residential Care, Inc.

  • Assisted Living Facility
  • Fontana, CA
National Provider Identifier
1790941714
Registry record updated Jul 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
366409921 Issued in CA
Legal business name
MOUNTAIN VIEW RESIDENTIAL CARE, INC.
Practice address
9073 Olive St
Fontana, CA 92335-4624
Phone
(909) 822-5174
Fax
(909) 822-8117
NPI assigned
Jul 29, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2008

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

Authorized official

Name
Mr. Alexander B. Ilagan
Title
Administrator
Phone
(909) 822-5174

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 366409921 CA Primary

Addresses

Primary practice location

9073 Olive St
Fontana, CA 92335-4624

Mailing address

9073 Olive St
Fontana, CA 92335-4624
Phone (909) 822-5174

National Provider Directory

National Provider Directory

Locations

9073 Olive St
Fontana, CA 92335
Phone (909) 822-5174

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1217289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217289600000",
    "number": "1790941714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9073 OLIVE ST",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923354624",
            "telephone_number": "909-822-5174",
            "fax_number": "909-822-8117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9073 OLIVE ST",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923354624",
            "telephone_number": "909-822-5174",
            "fax_number": "909-822-8117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN VIEW RESIDENTIAL CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-29",
        "last_updated": "2008-07-29",
        "status": "A",
        "authorized_official_last_name": "ILAGAN",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "909-822-5174",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CA",
            "license": "366409921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fontana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 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.