Organization Active NPI

J Squared, Inc.

Doing business as Mountain Villa Nursing Center

  • Skilled Nursing Facility
  • El Paso, TX
National Provider Identifier
1801931845
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
118223 Issued in TX
Legal business name
J SQUARED, INC.
Doing business as
Mountain Villa Nursing Center
Practice address
2729 Porter Ave
El Paso, TX 79930-3625
Phone
(915) 566-2111
Fax
(915) 562-6611
NPI assigned
Feb 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

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

Authorized official

Name
Donovan J Rivera
Title
Administrator
Phone
(915) 566-2111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 118223 TX Primary

Addresses

Primary practice location

2729 Porter Ave
El Paso, TX 79930-3625

Mailing address

11913 Paseo Dorado Cir
El Paso, TX 79936-3785
Phone (915) 566-2111

Other identifiers 1

IdentifierTypeStateIssuer
000538001MedicaidTX

Other names 1

  • Mountain Villa Nursing Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120731000398 TX Part A Provider - Skilled Nursing Facility 8628234291 Practice locations: El Paso, TX

Skilled nursing facility certification: CCN 675768

Legal name
J SQUARED, INC.
Doing business as
MOUNTAIN VILLA NURSING HOME
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Sep 1, 1998
Last certification
Sep 12, 2024
Beds
48
Ownership / control type
Corporation
Organization structure
CorporationProprietary
Incorporated
Jun 22, 1979 in TX
Enrollment address
2729 Porter Ave
El Paso, TX 79930-3625
Nursing home name
MOUNTAIN VILLA NURSING HOME

Care Compare: Nursing home

Medicare Care Compare
Listed as
Mountain Villa Nursing HomeCCN 675768 · All quality measures
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
2 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Sep 1, 1998
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
4838.4 residents per day on average

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D0964528Mountain Villa Nursing Center2729 Porter Avenue, El Paso, TX 79930Certificate of waiverAug 25, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Maharlika Resources, Inc Organization, El Paso, TX For-profit 5% Or Greater Direct Ownership Interest Jul 1, 1994 100%
Operational/Managerial Control Jul 1, 1994 100%
Donovan Rivera Individual 5% Or Greater Direct Ownership InterestOwner Mar 21, 2018 5%
W-2 Managing Employee Sep 27, 2011

Practitioners & affiliated clinicians

Practitioners 1

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

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744761600000",
    "number": "1801931845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11913 PASEO DORADO CIR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799363785",
            "telephone_number": "915-566-2111",
            "fax_number": "866-838-4666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2729 PORTER AVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799303625",
            "telephone_number": "915-566-2111",
            "fax_number": "915-562-6611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J SQUARED, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A",
        "authorized_official_last_name": "RIVERA",
        "authorized_official_first_name": "DONOVAN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "915-566-2111"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "118223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000538001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mountain Villa Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.