ARROWHEAD SENIOR VILLAS (NPI# 1417305004) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417305004 |
| Entity Type | Organization |
| Organization Name | ARROWHEAD SENIOR VILLAS |
| Practice Address |
2258 Mentone Blvd Mentone CA 92359-9582 |
| Practice Telephone | 9093019857 |
| Enumeration Date | 2016-05-25 |
| Last Update Date | 2016-05-25 |
| Authorized Official Name | ERIC SHAW (DIRECTOR) |
| Authorized Official Telephone | 9092520356 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320700000X | Residential Treatment Facility, Physical Disabilities | Residential Treatment Facilities |
| Street Address |
2258 MENTONE BLVD |
| City | MENTONE |
| State | CA |
| Zip Code | 92359-9582 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275010852 | Pingkan Leilani Simauw | Case Manager/Care Coordinator | 10360 Rock St, Mentone, CA 92359 | 2018-07-25 |
| 1861676033 | Laurel Elizabeth Slater | Registered Nurse | 34346 Fishhatchery Rd, Mentone, CA 92359 | 2007-12-24 |
| 1356530786 | Lisa M Coonrod | Registered Nurse | 34452 Fish Hatchery Rd, Mentone, CA 92359-0122 | 2007-10-22 |
| 1841759768 | Christy Hart | Counselor | 1336 Wabash Ave, Mentone, CA 92359-1124 | 2019-03-19 |
| 1790923753 | Rose Garden Residential Care | Alzheimer Center (Dementia Center) | 1350 Wabash Ave, Mentone, CA 92359-1124 | 2009-01-29 |
| 1851639405 | Rose Garden Residential Operator, LLC | Assisted Living Facility | 1350 Wabash Ave, Mentone, CA 92359-1124 | 2013-01-16 |
| 1801150164 | Tania Marie Mccracken | Midwife | 1378 Turquoise Ave, Mentone, CA 92359-1257 | 2012-07-01 |
| 1033263298 | James Patrick Caley Dds | Dentist | 1856 Mentone Blvd Ste B, Mentone, CA 92359-1276 | 2007-01-23 |
| 1770803546 | Building A Generation | Early Intervention Provider Agency | 1320 Crafton Ave, Mentone, CA 92359-1318 | 2010-06-03 |
| 1710544713 | Elizabeth An Hess | Behavior Technician | 1365 Crafton Ave Apt 2092, Mentone, CA 92359-1354 | 2019-05-24 |
| Find all providers in zip 92359 | ||||
| Taxonomy Code | 320700000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Physical Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881217974 | At Awe LLC | Residential Treatment Facility, Physical Disabilities | 10876 Morning Ridge Dr, Moreno Valley, CA 92557-4202 | 2020-05-22 |
| 1558980896 | Viewcrest Congregate Living | Residential Treatment Facility, Physical Disabilities | 7831 Melita Ave, North Hollywood, CA 91605-1820 | 2020-04-15 |
| 1962046524 | Randy Sarnillo Morelos | Residential Treatment Facility, Physical Disabilities | 9152 Chianti Circle, Stockton, CA 95212 | 2019-11-06 |
| 1518515618 | Dashonia Shaw | Residential Treatment Facility, Physical Disabilities | 3053 N Delno Ave, Fresno, CA 93705-4015 | 2019-08-31 |
| 1114572385 | Twet, LLC | Residential Treatment Facility, Physical Disabilities | 1682 Daybreak Pl, Escondido, CA 92027-1023 | 2019-08-05 |
| 1144873308 | Resurgence California, LLC | Residential Treatment Facility, Physical Disabilities | 3129 Pierce Ave, Costa Mesa, CA 92626-2827 | 2019-07-17 |
| 1891352019 | Mountain View Congregate Living, Inc. | Residential Treatment Facility, Physical Disabilities | 9001 Riderwood Dr, Sunland, CA 91040-2628 | 2019-05-22 |
| 1174014153 | Fresno Congregate Living Inc | Residential Treatment Facility, Physical Disabilities | 3110 E Sierra Ave, Fresno, CA 93710-5917 | 2018-05-24 |
| 1871090803 | Prestige Care Center | Residential Treatment Facility, Physical Disabilities | 474 Sunday Dr, Turlock, CA 95382-9625 | 2018-04-06 |
| 1699281584 | Derani Congregate Living, Inc. | Residential Treatment Facility, Physical Disabilities | 7344 Etiwanda Ave, Reseda, CA 91335-3103 | 2017-12-14 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.