{"npi":"1386629889","type":"NPI-2","status":"active","name":{"display":"Villa Convalescent Hospital Inc.","other":[],"organization_name":"VILLA CONVALESCENT HOSPITAL INC.","authorised_official":"Marc Johnson"},"specialty":{"primary_taxonomy":"314000000X","primary_taxonomy_description":"Skilled Nursing Facility","slug":"skilled-nursing-facility","schema_org_specialty":null,"all":[{"code":"314000000X","description":"Skilled Nursing Facility","primary":true,"state":"CA","license":"250000219"}]},"addresses":[{"purpose":"LOCATION","street_1":"8965 MAGNOLIA AVE","city":"RIVERSIDE","state":"CA","postal_code":"925034432","country_code":"US","phone":"9516895788"},{"purpose":"MAILING","street_1":"25910 ACERO STE 350","city":"MISSION VIEJO","state":"CA","postal_code":"926917908","country_code":"US","phone":"9494419258"}],"license":{"state":"CA","number":"250000219"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"ZZT05112G","state":"CA","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20140728001562","type_code":"00-18","type_desc":"PART A PROVIDER - SKILLED NURSING FACILITY","state":"CA","pac_id":"9436362795"}]},"enumeration_date":"2005-12-07","last_updated":"2024-04-05","_meta":{"source":"NPPES","snapshot_date":"2024-04-05","doc_url":"https://findmynpi.com/api"}}