Healthcare Provider Details

I. General information

NPI: 1982279329
Provider Name (Legal Business Name): UNIVERSAL HEALTH NET INLAND EMPIRE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2021
Last Update Date: 06/17/2022
Certification Date: 06/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 E KIMBALL AVE STE 2
HEMET CA
92543-4254
US

IV. Provider business mailing address

12 HOLLYLEAF
ALISO VIEJO CA
92656-2130
US

V. Phone/Fax

Practice location:
  • Phone: 949-690-5224
  • Fax:
Mailing address:
  • Phone: 949-690-5224
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: AMENHEH ABUSAFIEH
Title or Position: CEO/OWNER
Credential:
Phone: 949-690-5224