Active NPI
Legacy of Love Residence LLC
- Nursing Facility/Intermediate Care Facility
- Fontana, CA
National Provider Identifier
1811805047
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nursing Facility/Intermediate Care Facility
- Legal business name
- LEGACY OF LOVE RESIDENCE LLC
- Practice address
- 6819 Sunridge CT
Fontana, CA 92336-1420 - Phone
- (909) 833-1077
- NPI assigned
- Aug 29, 2026
- 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
- Isabelle R Wilcox, FNP-C
- Title
- Owner /Adminstrator/ Don
- Phone
- (909) 833-1077
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Facility/Intermediate Care Facility | 313M00000X | Primary |
Addresses
Primary practice location
6819 Sunridge CT
Fontana, CA 92336-1420
Mailing address
6819 Sunridge CT
Fontana, CA 92336-1420
Phone (909) 833-1077
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1787961600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1787961600000",
"number": "1811805047",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6819 SUNRIDGE CT",
"city": "FONTANA",
"state": "CA",
"postal_code": "923361420",
"telephone_number": "909-833-1077"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6819 SUNRIDGE CT",
"city": "FONTANA",
"state": "CA",
"postal_code": "923361420",
"telephone_number": "909-833-1077"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LEGACY OF LOVE RESIDENCE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-08-29",
"last_updated": "2026-08-29",
"certification_date": "2026-08-29",
"status": "A",
"authorized_official_last_name": "WILCOX",
"authorized_official_first_name": "ISABELLE",
"authorized_official_middle_name": "R",
"authorized_official_title_or_position": "OWNER /ADMINSTRATOR/ DON",
"authorized_official_telephone_number": "909-833-1077",
"authorized_official_credential": "FNP-C"
},
"taxonomies": [
{
"code": "313M00000X",
"taxonomy_group": "",
"desc": "Nursing Facility/Intermediate Care Facility",
"state": null,
"license": null,
"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 Aug 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.