VISTA PACIFICA ENTERPRISES
NPI 1801911797
Intermediate Care Facility, Intellectual Disabilities in Rialto, CA

Q: What is Holly House's NPI number?

The NPI number for Holly House is 1801911797. It was assigned to this organization in the NPPES registry on March 20, 2007. The provider is also known as Vista Pacifica Enterprises.

Q: What is Holly House's specialty?

The primary specialty registered for this NPI is Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.

Q: When was this NPI record last updated?

The NPPES record for Holly House was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.

Active since March 20, 2007

773 E HOLLY ST, RIALTO, CA 92376(909) 874-7690(909) 874-8689 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 23, 2026.

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About Vista Pacifica Enterprises NPPES

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

VISTA PACIFICA ENTERPRISES (NPI 1801911797) is a healthcare organization registered as an intermediate care facility, intellectual disabilities in Rialto, California and active in the NPI registry since March 2007. The organization lists Cheryl Jumonville, Exec Vice President, as its authorized official.

NPPES Registry Identity

NPI1801911797

Entity TypeOrganization

Primary Taxonomy315P00000X

Legal Business NameHOLLY HOUSE

Location Address773 E HOLLY STRialto, CA 92376-4520

Mailing Address3674 Pacific AveRiverside, CA 92509-1948 · (951) 682-4833 · Fax (951) 682-1503

Phone(909) 874-7690

Fax(909) 874-8689

Organization SubpartNo

Authorized OfficialCheryl JumonvilleExec Vice President · (951) 682-4833

Enumeration DateMarch 20, 2007

Last NPPES UpdateAugust 22, 2020

✔ NPI 1801911797 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyIntermediate Care Facility, Intellectual DisabilitiesNursing & Custodial Care Facilities

Taxonomy Code315P00000X

Definition

An intermediate care facility providing services for individuals with intellectual disabilities.

773 E HOLLY ST, Rialto, CA 92376

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Other Names 1

Other NameVista Pacifica Enterprises

Other Identifiers 1

Medicaid2400000518CA

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 Holly House's NPI number?

The NPI number for Holly House is 1801911797. It was assigned to this organization in the NPPES registry on March 20, 2007. The provider is also known as Vista Pacifica Enterprises.

Where is Holly House located?

Holly House is located at 773 E Holly St, Rialto, CA 92376. The listed phone number is (909) 874-7690.

What is Holly House's specialty?

The primary specialty registered for this NPI is Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.

When was this NPI record last updated?

The NPPES record for Holly House was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.