Healthcare Provider Details

I. General information

NPI: 1184429185
Provider Name (Legal Business Name): IMPERIAL VALLEY HEALTHCARE DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2025
Last Update Date: 08/06/2025
Certification Date: 08/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 W LEGION RD
BRAWLEY CA
92227-7780
US

IV. Provider business mailing address

207 W LEGION RD
BRAWLEY CA
92227-7780
US

V. Phone/Fax

Practice location:
  • Phone: 760-351-3341
  • Fax: 760-351-3155
Mailing address:
  • Phone: 760-351-3341
  • Fax: 760-351-3155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: CARLY LOPER
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 760-351-3594