# FONTANA HEALTHCARE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CASA MARIA HEALTHCARE CENTER
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114096120
- **Authorized official:** MRS. JEOUNG LEE (PRESIDENT CEO)
- **Authorized official phone:** (805) 494-1233

## Contact information

- **Practice address:** 17933 SAN BERNARDINO AVE, FONTANA, CA 92335-6151
- **Practice address phone:** (909) 877-1555
- **Mailing address:** 250 FAIRVIEW RD, THOUSAND OAKS, CA 91361-2456
- **Mailing address phone:** (805) 494-1233
- **Mailing address fax:** (805) 494-1411

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | CA | Yes |

## Other

- **Enumeration date:** 11/06/2006
- **Last updated:** 08/22/2020