Healthcare Provider Details

I. General information

NPI: 1699908962
Provider Name (Legal Business Name): IMPERIAL HEIGHTS HEALTHCARE & WELLNESS CENTRE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2009
Last Update Date: 10/19/2022
Certification Date: 10/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 CATTLE CALL DR
BRAWLEY CA
92227-3108
US

IV. Provider business mailing address

320 CATTLE CALL DR
BRAWLEY CA
92227-3108
US

V. Phone/Fax

Practice location:
  • Phone: 760-344-5431
  • Fax: 760-344-8240
Mailing address:
  • Phone: 760-344-5431
  • Fax: 760-344-8240

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: MR. JONATHAN WEISS
Title or Position: MEMBER
Credential:
Phone: 323-481-8441