BROADWATER BELLA VISTA CARE CENTER, LLC (NPI# 1679616528) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679616528 |
| Entity Type | Organization |
| Organization Name | BROADWATER BELLA VISTA CARE CENTER, LLC |
| Other Organization Name | BELLA VISTA HEALTHCARE CENTER |
| Practice Address |
933 E Deodar St Ontario CA 91764-1309 |
| Practice Telephone | 9099852731 |
| Practice Fax Number | 9099851414 |
| Mailing Telephone | 9099852731 |
| Mailing Fax Number | 9099851414 |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2008-06-09 |
| Authorized Official Name | DOUGLAS EASTON (MANAGER) |
| Authorized Official Telephone | 8183681862 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 240000113 | CA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 1679616528 | 05 |
| Other Name | Type Code |
|---|---|
| Bella Vista Healthcare Center | Doing Business As Name - Organization |
| Street Address |
933 E DEODAR ST |
| City | ONTARIO |
| State | CA |
| Zip Code | 91764-1309 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043207384 | Bella Vista Operating Company Inc | Skilled Nursing Facility | 933 E Deodar St, Ontario, CA 91764-1309 | 2005-10-03 |
| 1437559606 | Ontario Grove Healthcare & Wellness Centre, Lp | Skilled Nursing Facility | 933 E Deodar St, Ontario, CA 91764-1309 | 2014-08-25 |
| 1699018739 | Country Villa Imperial, LLC | Skilled Nursing Facility | 933 E Deodar St, Ontario, CA 91764-1309 | 2013-03-27 |
| 1417215328 | Anabi Medical Corp | Internal Medicine | 933 E Deodar St, Ontario, CA 91764-1309 | 2012-04-27 |
| 1174822241 | Kf Bella Vista LLC | Skilled Nursing Facility | 933 E Deodar St, Ontario, CA 91764-1309 | 2011-03-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760096952 | Jacqueline Iriart | Behavior Technician | 2930 Inland Empire Blvd St 100, Ontario, CA 91764 | 2020-09-03 |
| 1306459573 | Loremari Samantha Mohr | Assistant Behavior Analyst | 4688 Ontario Mills Parkwar, Ontario, CA 91764 | 2020-08-28 |
| 1023629649 | Yazmin Ramos | Behavior Technician | 4688 Ontario Mills Pwky, Ontario, CA 91764 | 2020-08-17 |
| 1184234999 | Adoniram Morales | Behavior Technician | 4688 Ontatio Mills Parkway, Ontario, CA 91764 | 2020-08-06 |
| 1396395489 | Enhanced Sleep Solutions | Clinic/Center | 2990 E. Inland Empire Blvd. #105, Antonio, CA 91764 | 2019-09-19 |
| 1013561588 | Jaquelyn Herrera | Behavior Technician | 2151 E Convention Center Way Ste #103, Ontario, CA 91764 | 2019-08-01 |
| 1285287995 | Ha Tran Tsai Dental Corporation | Dentist | 1361 East 4th Street, Ontario, CA 91764 | 2019-07-22 |
| 1346702974 | Rocio Sandoval | Behavior Technician | 800 Ferrari Ln Ste 100, Ontario, CA 91764 | 2019-04-02 |
| 1275011678 | Jquana Lucille Dowdy | Behavior Technician | 2903 Inland Empire Blvd, Suite 101, Ontario, CA 91764 | 2018-07-30 |
| 1063917458 | Maria Veronica Heard | Specialist/Technologist | 740 E Princeton St, Ontario, CA 91764 | 2018-03-27 |
| Find all providers in zip 91764 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043207384 | Bella Vista Operating Company Inc | Skilled Nursing Facility | 933 E Deodar St, Ontario, CA 91764-1309 | 2005-10-03 |
| 1548255466 | Presbyterian Nursing Home | Skilled Nursing Facility | 1085 N Oregon St, Ontario, OR 97914-1549 | 2005-09-16 |
| 1649271339 | Plott Nursing Home, LLC | Skilled Nursing Facility | 800 E 5th St, Ontario, CA 91764-2432 | 2005-08-03 |
| 1093711681 | Inland Christian Home, Inc. | Skilled Nursing Facility | 1950 S Mountain Ave, Ontario, CA 91762-6723 | 2005-06-28 |
| 1063810349 | Ontarioidence Opco, LLC | Skilled Nursing Facility | 800 E 5th St, Ontario, CA 91764-2432 | 2014-12-18 |
| 1437559606 | Ontario Grove Healthcare & Wellness Centre, Lp | Skilled Nursing Facility | 933 E Deodar St, Ontario, CA 91764-1309 | 2014-08-25 |
| 1073920948 | Diversicare of Mansfield, LLC | Skilled Nursing Facility | 2124 Park Ave W, Ontario, OH 44906-3807 | 2014-07-12 |
| 1699018739 | Country Villa Imperial, LLC | Skilled Nursing Facility | 933 E Deodar St, Ontario, CA 91764-1309 | 2013-03-27 |
| 1174822241 | Kf Bella Vista LLC | Skilled Nursing Facility | 933 E Deodar St, Ontario, CA 91764-1309 | 2011-03-15 |
| 1780900068 | Kf Ontario Healthcare LLC | Skilled Nursing Facility | 1661 S Euclid Ave, Ontario, CA 91762-5826 | 2010-04-12 |
| Find all providers in ONTARIO | ||||
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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.