# MONTELAGO CONGREGATE LIVING, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356120307
- **Authorized official:** MR. EARL BONNER RRT/RCT (ADMINISTRATOR)
- **Authorized official phone:** (951) 662-0719

## Contact information

- **Practice address:** 12537 POINSETTA DR, RIVERSIDE, CA 92503-7067
- **Practice address phone:** (909) 643-1009
- **Practice address fax:** (951) 643-1031
- **Mailing address:** 20816 CENTER STREET, RIVERSIDE, CA 92507
- **Mailing address phone:** (909) 643-1009
- **Mailing address fax:** (951) 643-1031

## Taxonomy

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

## Other

- **Enumeration date:** 09/27/2023
- **Last updated:** 05/16/2025