MEDICARE: EMBER CARE HLTH CENTER OF PERRIS CALIFORNIA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility		CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518957513
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMBER CARE HLTH CENTER OF PERRIS CALIFORNIA

Provider Business Mailing Address
First Line	:	2225 N PERRIS BLVD
Second Line	:
City	:	PERRIS
State	:	CA
Zip	:	92571-2580
Country	:	US
Telephone Number	:	951-657-2135
Fax Number	:	951-657-6145

Provider Business Practice Location Address
First Line	:	2225 N PERRIS BLVD
Second Line	:
City	:	PERRIS
State	:	CA
Zip	:	92571-2580
Country	:	US
Telephone Number	:	951-657-2135
Fax Number	:	951-657-6145

Authorized Official
Title or Position	:	NURSING HOME ADMINISTRATOR
Name	:	MR. ROBERT RIVERA TELLES
Credential	:	CA, NHA #2035
Telephone Number	:	951-657-2135

Provider Enumeration Date	:	10/21/2005
Last Update Date	:	08/22/2020

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Directions to “EMBER CARE HLTH CENTER OF PERRIS CALIFORNIA ” Practice Location

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