Healthcare Provider Details

I. General information

NPI: 1518957513
Provider Name (Legal Business Name): EMBER CARE HLTH CENTER OF PERRIS CALIFORNIA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2225 N PERRIS BLVD
PERRIS CA
92571-2580
US

IV. Provider business mailing address

2225 N PERRIS BLVD
PERRIS CA
92571-2580
US

V. Phone/Fax

Practice location:
  • Phone: 951-657-2135
  • Fax: 951-657-6145
Mailing address:
  • Phone: 951-657-2135
  • Fax: 951-657-6145

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: MR. ROBERT RIVERA TELLES
Title or Position: NURSING HOME ADMINISTRATOR
Credential: CA, NHA #2035
Phone: 951-657-2135