NPIMap

Organization Active NPI

Foothill Care Center II, LLC

Doing business as Morris Home

  • Adult Care Home Facility
  • West Covina, CA
National Provider Identifier
1871715193
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
Legal business name
FOOTHILL CARE CENTER II, LLC
Doing business as
Morris Home
Practice address
332 N Morris Ave
West Covina, CA 91790-1411
Phone
(626) 851-8030
NPI assigned
May 3, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Miss Eden De Asis Salceda
Title
Administrator
Phone
(626) 962-3274

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X CA Primary

Addresses

Primary practice location

332 N Morris Ave
West Covina, CA 91790-1411

Mailing address

1758 Big Dalton Ave
Baldwin Park, CA 91706-5910
Phone (626) 932-3274

Other identifiers 1

IdentifierTypeStateIssuer
LTC60937FMedicaidCA

Other names 1

  • Morris Home Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1871715193. Details of each certification follow.

  • CCN 55G310 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 55G310

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
MORRIS HOME
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Oct 14, 1999
Last certification
Feb 26, 2025
Beds
6
Ownership / control type
Private (non-profit)
Facility address
332 N Morris Avenue
West Covina, CA 91790

National Provider Directory

National Provider Directory
Tax ID family
Foothill Care Center II LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1871715193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1758 BIG DALTON AVE",
            "city": "BALDWIN PARK",
            "state": "CA",
            "postal_code": "917065910",
            "telephone_number": "626-932-3274",
            "fax_number": "626-962-4424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "332 N MORRIS AVE",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917901411",
            "telephone_number": "626-851-8030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOTHILL CARE CENTER II, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SALCEDA",
        "authorized_official_first_name": "EDEN",
        "authorized_official_middle_name": "DE ASIS",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "626-962-3274",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC60937F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Morris Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Covina, CA

Sources for this page

Verify at the official NPI Registry.