Healthcare Provider Details

I. General information

NPI: 1720925589
Provider Name (Legal Business Name): MARCELA CONGREGATE LIVING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1969 N LILAC AVENUE
RIALTO CA
92376
US

IV. Provider business mailing address

6010 EL RANCHO DR
WHITTIER CA
90606-1414
US

V. Phone/Fax

Practice location:
  • Phone: 949-447-4839
  • Fax: 888-789-0799
Mailing address:
  • Phone: 949-447-4839
  • Fax: 888-789-0799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. TESALONICA DIONISIO CLEMENTE
Title or Position: ADMINISTRATOR, CEO
Credential: RN,
Phone: 949-447-4839