AUTUMN BLISS HOME LLC NPI 1669236626

NPI Information

  • NPI: 1669236626
  • Provider Name: AUTUMN BLISS HOME LLC
  • Classification: Assisted Living Facility - 310400000X
  • Entity Type: Organization
  • Address: 17885 ATHOL ST
    FONTANA, CA
    ZIP 92335
  • Phone: (626) 373-7619

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NPI Details

AUTUMN BLISS HOME LLC is an assisted living facility in Fontana, CA. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. AUTUMN BLISS HOME LLC NPI is 1669236626. The provider is registered as an organization entity type.

The provider's business location address is:

17885 ATHOL ST
FONTANA, CA
ZIP 92335-127
Phone: (626) 373-7619

The provider's authorized official is Regine Enriquez .
The authorized official title is Licensee and has the following contact phone number (626) 373-7619.

The enumeration date for this NPI number is 2/9/2024 and was last updated on 2/9/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1310400000XAssisted Living FacilityYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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