EAGLE GLEN CARE HOME LLC (NPI# 1710395777) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710395777 |
| Entity Type | Organization |
| Organization Name | EAGLE GLEN CARE HOME LLC |
| Practice Address |
1697 Honors Cir Corona CA 92883-0757 |
| Practice Telephone | 9515829230 |
| Practice Fax Number | 9513402740 |
| Mailing Telephone | 9515829230 |
| Mailing Fax Number | 9513402740 |
| Enumeration Date | 2014-07-23 |
| Last Update Date | 2014-07-23 |
| Authorized Official Name | RESTITUTO CALILUNG (LICENSEE) |
| Authorized Official Telephone | 7149066046 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | 336426012 | CA | Nursing & Custodial Care Facilities |
| Street Address |
1697 HONORS CIR |
| City | CORONA |
| State | CA |
| Zip Code | 92883-0757 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710496815 | Onyinye Yvonne Johnson | Nurse Practitioner | 27223 Lasso Way, Corona, CA 92883 | 2017-09-21 |
| 1215376850 | Jennifer Carol Bard | Speech-Language Pathologist | 4194 Floyd Drive, Corona, CA 92883 | 2013-06-17 |
| 1023359619 | Richard Joon Kim | Pharmacist | 4315 Driving Range Rd, Corona, CA 92883 | 2013-03-07 |
| 1740590330 | Kim-thoa Thi Vu | Pharmacist | 2243 Eagle Glen Parkway, Corona, CA 92883 | 2010-10-15 |
| 1114232154 | Always 'tfy' Hospice, Inc. | Hospice Care, Community Based | 9064 Pulsar Court, Ste E, Corona, CA 92883 | 2010-08-14 |
| 1952553844 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 11950 Depalma Rd, Corona, CA 92883 | 2008-10-22 |
| 1497979280 | Sang C Paik Dds | Dentist | 3811 Bedford Canyon Rd, Suite 105, Corona, CA 92883 | 2007-04-12 |
| 1285615864 | Mallory Leon | Family Medicine | 25085 Pacific Crest Street, Corona, CA 92883 | 2005-11-09 |
| 1326038993 | Chan Woo Lee | Optometrist | 2790 Cabot Drive, Suite 135, Corona, CA 92883 | 2005-10-25 |
| 1659575736 | Optique Optometry, A Professional Corporation | Optometrist | 2790 Cabot Drive, Suite 135, Corona, CA 92883 | 2007-06-13 |
| Find all providers in zip 92883 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124585658 | Gabriela Care Home, Inc. | Assisted Living Facility | 1717 Tamarron Dr, Corona, CA 92883-0765 | 2019-02-20 |
| 1639539695 | Cresencia Care Home LLC | Assisted Living Facility | 1785 Honors Ln, Corona, CA 92883-0759 | 2016-03-03 |
| 1588861512 | Madison York Assisted Living Community LLC | Assisted Living Facility | 11214 Corona Ave, Corona, NY 11368-4022 | 2007-07-02 |
| 1033241237 | Castle Senior Living At Forest Hills | Assisted Living Facility | 10825 Horace Harding Expy, Corona, NY 11368-4532 | 2007-03-12 |
| 1346210788 | Pleasant Care Corona | Assisted Living Facility | 1400 E Circle City Dr, Corona, CA 92879 | 2006-01-26 |
| 1295254316 | Corona Rcfe | Assisted Living Facility | 2600 S Main St, Corona, CA 92882-5941 | 2017-09-11 |
| 1699153726 | Corona Residential Care Center LLC | Assisted Living Facility | 1400 Circle City Dr, Corona, CA 92879-1642 | 2015-05-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710588165 | Nana's Garden II | Assisted Living Facility | 25312 Ericson Way, Laguna Hills, CA 92653-5054 | 2020-11-03 |
| 1609476589 | Southbay Care Home, Inc. | Assisted Living Facility | 19917 Anza Avenue, Torrance, CA 90503-2005 | 2020-10-29 |
| 1821697434 | Global Regency Senior Care Services, LLC | Assisted Living Facility | 117 E 8th St, Long Beach, CA 90813-4397 | 2020-10-23 |
| 1689273419 | Pacifica Slo LLC | Assisted Living Facility | 475 Marsh St, San Luis Obispo, CA 93401-6108 | 2020-10-22 |
| 1871192682 | Pacifica Sfo LLC | Assisted Living Facility | 624 Laguna St, San Francisco, CA 94102-4217 | 2020-10-22 |
| 1528667367 | Pacifica Sierra Vista Lp | Assisted Living Facility | 13815 Rodeo Dr, Victorville, CA 92395-5600 | 2020-10-22 |
| 1992304737 | West Lyons Lp | Assisted Living Facility | 24305 Lyons Ave, Newhall, CA 91321-2344 | 2020-10-22 |
| 1619576451 | Pacifica Orange County LLC | Assisted Living Facility | 2619 Orange Ave, Costa Mesa, CA 92627-4630 | 2020-10-22 |
| 1720687551 | P San Leandro Lp | Assisted Living Facility | 348 W Juana Ave, San Leandro, CA 94577-3661 | 2020-10-22 |
| 1952900730 | Pacifica Daly LLC | Assisted Living Facility | 995 E Market St, Daly City, CA 94014-2168 | 2020-10-22 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on EAGLE GLEN CARE HOME LLC.
| 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.