Active NPI
J Squared, Inc.
Doing business as Mountain Villa Nursing Center
- Skilled Nursing Facility
- El Paso, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 118223
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000538001 | Medicaid | TX |
Other names 1
- Mountain Villa Nursing Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- Corporation
- 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 Home
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Sep 1, 1998
- Medicare certification status
- Active
- Certified beds
- 48
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D0964528 | Mountain Villa Nursing Center | Certificate of waiver | Aug 25, 2027 |
National Provider Directory
National Provider DirectoryOwnership & 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.
| Name | Role | Since | Share |
|---|---|---|---|
| Maharlika Resources, Inc | 5% Or Greater Direct Ownership Interest | Jul 1, 1994 | 100% |
| Operational/Managerial Control | Jul 1, 1994 | 100% | |
| Donovan Rivera | 5% Or Greater Direct Ownership Interest | 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.
-
- Geriatric Medicine (Internal Medicine) Physician
- El Paso, TX
- NPI 1568477321
Affiliated clinicians 1
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Geriatric Medicine (Internal Medicine) Physician
- El Paso, TX
- NPI 1568477321
Nursing home
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.