FERN HOME 1 LLC (NPI# 1972029486) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972029486 |
| Entity Type | Organization |
| Organization Name | FERN HOME 1 LLC |
| Other Organization Name | FERN HOME 1 |
| Practice Address |
3875 Megginson Ln Riverside CA 92503-3425 |
| Mailing Address |
3875 Megginson Lane Riverside CA 92503 |
| Practice Telephone | (310) 997-8204 |
| Mailing Telephone | 3109978204 |
| Enumeration Date | 2017-08-16 |
| Last Update Date | 2017-08-16 |
| Authorized Official Name | JOI MAE GUBALANE (LICENSEE/ADMINISTRATOR) |
| Authorized Official Telephone | 3109978204 |
| Authorized Official Credential | RCFE ADMINISTRAT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | 331800142 | CA | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| FERN HOME 1 | Other Name - Individual/Organization |
| Street Address |
3875 MEGGINSON LN |
| City | RIVERSIDE |
| State | CA |
| Zip Code | 92503-3425 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255953618 | Mohammad Abul-fielat Dds Inc | Dentist | 3825 Tyler St, Riverside, CA 92503 | 2020-05-08 |
| 1205396488 | Francisco Aguayo | Behavioral Analyst | 3345 Jackson St, Riverside, CA 92503 | 2019-03-22 |
| 1073071684 | Racheal Ego Aneke | Nurse Practitioner | 9890 County Farm Rd., Building 2, Riverside, CA 92503 | 2019-03-04 |
| 1073070264 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 3500 Tyler Mall, Riverside, CA 92503 | 2019-02-25 |
| 1053893271 | Tsibel Dental Practice Inc. | Dentist | 10181 Magnolia Ave, Riverside, CA 92503 | 2018-09-04 |
| 1508344714 | Patricia Marraine Redondo | Counselor | 1625 14th St, Riverside, CA 92503 | 2018-07-31 |
| 1740766146 | Robles Rodef & Yaghoubi Dental Corporation | Dentist | 5628 Van Buren Blvd Suite #a, Riverside, CA 92503 | 2018-07-18 |
| 1467961755 | Daniela Popa | Assisted Living Facility | 10820 Calle Bella, Riverside, CA 92503 | 2017-09-29 |
| 1457860306 | Leah Dreany | Peer Specialist | 2085 Rustin Avenue Building #3, Riverside, CA 92503 | 2017-09-22 |
| 1710400445 | Christopher John Guting | Peer Specialist | 10230 Indiana Avenue, Riverside, CA 92503 | 2017-07-25 |
| Find all providers in zip 92503 | ||||
| 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 |
|---|---|---|---|---|
| 1588280788 | Yenny M Vieyra Aviles | Assisted Living Facility | 3879 Lafayette St, Riverside, CA 92503-3821 | 2020-06-23 |
| 1326672973 | Blessed Elder Care Inc | Assisted Living Facility | 5041 Sierra St, Riverside, CA 92504-2260 | 2020-02-22 |
| 1518504786 | Faith Hope and Love Assisted Living, Inc. | Assisted Living Facility | 5505 Via San Jacinto, Riverside, CA 92506-3652 | 2019-12-05 |
| 1477037299 | California Home for The Adult Deaf | Assisted Living Facility | 3615 Crowell Ave, Riverside, CA 92504-3549 | 2018-09-18 |
| 1790265650 | Juan Cornell | Assisted Living Facility | 1622 Palermo Dr, Riverside, CA 92507-2393 | 2018-08-20 |
| 1467961755 | Daniela Popa | Assisted Living Facility | 10820 Calle Bella, Riverside, CA 92503 | 2017-09-29 |
| 1255755237 | Caloaks Care Group Inc | Assisted Living Facility | 3891 Polk St, Riverside, CA 92505-1703 | 2014-02-11 |
| 1386965424 | Senior Focus Residential Care | Assisted Living Facility | 871 Via Mindi, Riverside, CA 92506-3642 | 2010-06-11 |
| 1780913475 | Summerville At Cobbco, Inc. | Assisted Living Facility | 5881 El Palomino Dr, Riverside, CA 92509-7006 | 2009-12-09 |
| 1528233392 | James L Webb Enterprises Inc | Assisted Living Facility | 3100 Nw Vivion Rd, Riverside, MO 64150-9436 | 2008-04-23 |
| Find all providers in RIVERSIDE | ||||
Please comment or provide details below to improve the information on FERN HOME 1 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.