Healthcare Provider Details

I. General information

NPI: 1295772531
Provider Name (Legal Business Name): CHAPMAN CONVALESCENT HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 08/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4301 CAROLINE CT
RIVERSIDE CA
92506-2902
US

IV. Provider business mailing address

4301 CAROLINE CT
RIVERSIDE CA
92506-2902
US

V. Phone/Fax

Practice location:
  • Phone: 951-683-7111
  • Fax: 951-683-6826
Mailing address:
  • Phone: 951-683-7111
  • Fax: 951-683-6826

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number250000124
License Number StateCA

VIII. Authorized Official

Name: MR. RAYMOND NELSON BEEMAN
Title or Position: PRESIDENT
Credential:
Phone: 951-683-7111