NPIMap

Organization Active NPI

Our Lady of Mercy Home Icf-DDH

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • West Covina, CA
National Provider Identifier
1801173026
Registry record updated Nov 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
Legal business name
OUR LADY OF MERCY HOME ICF-DDH
Practice address
3845 S Morganfield Ave
West Covina, CA 91792-3238
Phone
(909) 444-5796
Fax
(909) 594-3604
NPI assigned
Nov 16, 2011
Last updated
Nov 16, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2011

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

Authorized official

Name
Mrs. Lydia S Sebastian
Title
Owner
Phone
(909) 578-5453

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X CA Primary

Addresses

Primary practice location

3845 S Morganfield Ave
West Covina, CA 91792-3238

Mailing address

PO Box 1862
Walnut, CA 91788-1862
Phone (909) 444-5796

National Provider Directory

National Provider Directory
Tax ID family
Our Lady of Mercy Home3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1321401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321401600000",
    "number": "1801173026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1862",
            "city": "WALNUT",
            "state": "CA",
            "postal_code": "917881862",
            "telephone_number": "909-444-5796",
            "fax_number": "909-594-3604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3845 S MORGANFIELD AVE",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917923238",
            "telephone_number": "909-444-5796",
            "fax_number": "909-594-3604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUR LADY OF MERCY HOME ICF-DDH",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-16",
        "last_updated": "2011-11-16",
        "status": "A",
        "authorized_official_last_name": "SEBASTIAN",
        "authorized_official_first_name": "LYDIA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-578-5453",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2011; 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.