Organization
MONTELAGO CONGREGATE LIVING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EARL BONNER RRT/RCT (ADMINISTRATOR)
(951) 662-0719
Entity
Organization
Contact information
Practice address
12537 POINSETTA DR, RIVERSIDE, CA 92503-7067
(909) 643-1009
(951) 643-1031
Mailing address
20816 CENTER STREET, RIVERSIDE, CA 92507
(909) 643-1009
(951) 643-1031
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
09/27/2023
Last updated
05/16/2025
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