LOTUS VILLA AFFILIATE LLC
NPI 1639884687
Assisted Living Facility in Fontana, CA

Q: What is Lotus Villa Affiliate LLC's NPI number?

The NPI number for Lotus Villa Affiliate LLC is 1639884687. It was assigned to this organization in the NPPES registry on January 13, 2023. The provider is doing business as Lotus Villa and Memory Care.

Q: What is Lotus Villa Affiliate LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Active since January 13, 2023

9448 CITRUS AVE, FONTANA, CA 92335(909) 355-6887 Get Directions Write a Review

NPPES record last updated: January 13, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Lotus Villa Affiliate Llc NPPES

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

LOTUS VILLA AFFILIATE LLC (NPI 1639884687), doing business as Lotus Villa And Memory Care, is a healthcare organization registered as an assisted living facility in Fontana, California and active in the NPI registry since January 2023. The organization lists Ezequiel Bercovich, Manager, as its authorized official.

NPPES Registry Identity

NPI1639884687

Entity TypeOrganization

Primary Taxonomy310400000X

Legal Business NameLOTUS VILLA AFFILIATE LLC

Location Address9448 CITRUS AVEFontana, CA 92335-5512

Mailing Address9448 Citrus AveFontana, CA 92335-5512 · (909) 355-6887

Phone(909) 355-6887

Organization SubpartNo

Authorized OfficialEzequiel BercovichManager · (213) 948-0913

Enumeration DateJanuary 13, 2023

NPPES CertifiedJanuary 13, 2023

✔ NPI 1639884687 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities

Taxonomy Code310400000X

Definition

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.

9448 CITRUS AVE, Fontana, CA 92335

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Other Names 1

Doing Business AsLotus Villa And Memory Care

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.

CITRUS VILLA RETIREMENT CENTER

Assisted Living Facility

9448 CITRUS AVE
FONTANA, CA 92335

San Bernardino County (909) 823-0631

KP HEALTHCARE - DBA LOTUS VILLA MEMORY CARE

Assisted Living Facility (Assisted Living, Behavioral Disturbances)

9448 CITRUS AVE
FONTANA, CA 92335

San Bernardino County (909) 355-6887

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 Lotus Villa Affiliate LLC's NPI number?

The NPI number for Lotus Villa Affiliate LLC is 1639884687. It was assigned to this organization in the NPPES registry on January 13, 2023. The provider is doing business as Lotus Villa and Memory Care.

Where is Lotus Villa Affiliate LLC located?

Lotus Villa Affiliate LLC is located at 9448 Citrus Ave, Fontana, CA 92335. The listed phone number is (909) 355-6887.

What is Lotus Villa Affiliate LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

When was this NPI record last updated?

The NPPES record for Lotus Villa Affiliate LLC was last updated on January 13, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.