Healthcare Provider Details

I. General information

NPI: 1326167453
Provider Name (Legal Business Name): GOLDEN CROSS CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 N SAN JACINTO ST
HEMET CA
92543-4453
US

IV. Provider business mailing address

275 N SAN JACINTO ST
HEMET CA
92543-4453
US

V. Phone/Fax

Practice location:
  • Phone: 951-648-9441
  • Fax: 951-766-1908
Mailing address:
  • Phone: 951-648-9441
  • Fax: 951-766-1908

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateCA

VIII. Authorized Official

Name: MRS. ISIDRA AGULTO
Title or Position: ADMINISTRATOR
Credential:
Phone: 951-658-9441