Provider Demographics
NPI:1962499202
Name:ONTARIO OPERATING COMPANY INC
Entity Type:Organization
Organization Name:ONTARIO OPERATING COMPANY INC
Other - Org Name:ONTARIO HEALTHCARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:REISS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-368-5200
Mailing Address - Street 1:1661 S EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91762-5826
Mailing Address - Country:US
Mailing Address - Phone:909-984-6713
Mailing Address - Fax:909-984-5254
Practice Address - Street 1:1661 S EUCLID AVE
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91762-5826
Practice Address - Country:US
Practice Address - Phone:909-984-6713
Practice Address - Fax:909-984-5254
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-03
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZT05707JMedicaid
CAZZT05707JMedicaid
CA055707Medicare ID - Type Unspecified