COUNTRY VILLA HACIENDA HEALTHCARE CENTER
NPI 1477547750
Skilled Nursing Facility in San Bernardino, CA

Active since September 01, 2005
1311 E DATE ST, SAN BERNARDINO, CA 92404(909) 882-3316(909) 882-5126 Get Directions Write a Review

NPPES record last updated: February 4, 2014. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Country Villa Hacienda Healthcare Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COUNTRY VILLA HACIENDA HEALTHCARE CENTER (NPI 1477547750) is a healthcare organization registered as a skilled nursing facility in San Bernardino, California and active in the NPI registry since September 2005. The organization lists Stephen E. Reissman, Trustee Of Managing Member, as its authorized official.

NPPES Registry Identity

NPI1477547750
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameMOUNTAINSIDE OPERATING COMPANY, LLC
Location Address1311 E DATE STSan Bernardino, CA 92404-4233
Mailing Address5120 W Goldleaf Cir, Suite 400Los Angeles, CA 90056-1292 · (310) 574-3733 · Fax (310) 574-1322
Fax(909) 882-5126
Organization SubpartNo
Authorized OfficialStephen E. ReissmanTrustee Of Managing Member · (310) 574-3733
Enumeration DateSeptember 1, 2005
Last NPPES UpdateFebruary 4, 2014
NPI 1477547750 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License Licensed in CA · 240000136
Definition
(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.
1311 E DATE ST, San Bernardino, CA 92404

Other Names 1

Doing Business AsCountry Villa Hacienda Healthcare Center

Other Identifiers 2

Medicare ID-Type Unspecified056053CA
MedicaidZZT06053JCA

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Skilled Nursing Facility
1311 E DATE ST
SAN BERNARDINO, CA 92404
Skilled Nursing Facility
1311 E DATE ST
SAN BERNARDINO, CA 92404

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mountainside Operating Company, LLC's NPI number?

The NPI number for Mountainside Operating Company, LLC is 1477547750. It was assigned to this organization in the NPPES registry on September 1, 2005. The provider is doing business as Country Villa Hacienda Healthcare Center.

Where is Mountainside Operating Company, LLC located?

Mountainside Operating Company, LLC is located at 1311 E Date St, San Bernardino, CA 92404. The listed phone number is (909) 882-3316.

What is Mountainside Operating Company, LLC's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

When was this NPI record last updated?

The NPPES record for Mountainside Operating Company, LLC was last updated on February 4, 2014. NPI Profile syncs with the weekly NPPES data releases published by CMS.