Healthcare Provider Details

I. General information

NPI: 1346346285
Provider Name (Legal Business Name): CITRUS NURSING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 09/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9440 CITRUS AVE
FONTANA CA
92335
US

IV. Provider business mailing address

3050 SATURN ST STE 201
BREA CA
92821-6278
US

V. Phone/Fax

Practice location:
  • Phone: 909-823-3481
  • Fax: 909-823-3829
Mailing address:
  • Phone: 714-577-3880
  • Fax: 714-577-3895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number240000127
License Number State

VIII. Authorized Official

Name: WILLIAM C PRESNELL
Title or Position: CFO
Credential:
Phone: 714-577-3880