NPI: 1639884687 · FONTANA, CA 92335 · Assisted Living Facility · NPI assigned 01/13/2023
| Authorized Official | BERCOVICH, EZEQUIEL (MANAGER) |
| NPI Enumeration Date | 01/13/2023 |
| Year | Claims | Total Paid |
|---|---|---|
| 2024 | 146 | $150K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| T2031 | Assisted living; waiver, per diem | 146 | 45 | $150K |