Parkmount Manor LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

PARKMOUNT MANOR LLC

Practice address

1001 Yardley Way
Corona, CA 92881-7434

Phone

(951) 870-7189

NPI assigned

Feb 21, 2024

Organization subpart

No

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

Authorized official

Name

Geoffrey Brouillette

Title

Ceo

Phone

(951) 870-7189

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1708473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734480000000",
    "number": "1861258485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4264 WINDSPRING CIR",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928835925",
            "telephone_number": "951-870-7189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 YARDLEY WAY",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928817434",
            "telephone_number": "951-870-7189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKMOUNT MANOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-21",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A",
        "authorized_official_last_name": "BROUILLETTE",
        "authorized_official_first_name": "GEOFFREY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "951-870-7189"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenifer Ayn Parker Lopez, SLP
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• Kiara Parker
• Natalie Alexis Parker
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• Georgina Parra Martinez, DDS
• Shayla Guadalupe Parra
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• Assisted Living Facility in Corona, CA
• Providers in Corona, CA by specialty
• Assisted Living Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2024; 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.