Mom'S Retreat Board & Care Home , LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

MOM'S RETREAT BOARD & CARE HOME , LLC

Practice address

607 S Pine Dr
Fullerton, CA 92833-3633

Phone

(714) 770-0645

Fax

(888) 459-2407

NPI assigned

Aug 12, 2021

Organization subpart

No

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

Authorized official

Name

Ms. Gabriela Garcia

Title

Licensee/Administrator

Phone

(714) 770-0625

Specialties & licenses 1

Addresses

Other names 1

• Mom's Retreat Board & Care Home Doing business as

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

{
    "created_epoch": "1628726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628726400000",
    "number": "1881369742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 E ELLSWORTH AVE",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928054711",
            "telephone_number": "714-829-6024",
            "fax_number": "888-459-2407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 S PINE DR",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928333633",
            "telephone_number": "714-770-0645",
            "fax_number": "888-459-2407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOM'S RETREAT BOARD & CARE HOME , LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-12",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A",
        "authorized_official_last_name": "GARCIA",
        "authorized_official_first_name": "GABRIELA",
        "authorized_official_title_or_position": "LICENSEE/ADMINISTRATOR",
        "authorized_official_telephone_number": "714-770-0625",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mom's Retreat Board & Care Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Maura Molina
• Monica Molina
• Philip Martin Molina, DPT
• Christy C Molino
• Kesaya Moloi
• Monarch Medical Mangement, Inc.
• Meagan A Moncada
• Lorena Mondragon
• Veronica Mones, R.N.
• Kylie Ann Money

• Assisted Living Facility in Fullerton, CA
• Providers in Fullerton, 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 Aug 12, 2021; 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.