MJ Senior Homecare Services LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

MJ SENIOR HOMECARE SERVICES LLC

Practice address

2172 N Magnolia Ave
Rialto, CA 92377-4725

Phone

(909) 258-2563

NPI assigned

Jan 23, 2025

Last updated

Jan 23, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mabel Chanikornpradit

Title

Administrator

Phone

(909) 258-2563

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1737590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737590400000",
    "number": "1962214163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2172 N MAGNOLIA AVE",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923774725",
            "telephone_number": "909-258-2563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2172 N MAGNOLIA AVE",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923774725",
            "telephone_number": "909-258-2563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MJ SENIOR HOMECARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-23",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A",
        "authorized_official_last_name": "CHANIKORNPRADIT",
        "authorized_official_first_name": "MABEL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "909-258-2563"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Rialto, CA
• Providers in Rialto, 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 Jan 23, 2025; 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.