Healthcare Provider Details

I. General information

NPI: 1518451921
Provider Name (Legal Business Name): ARC CARE CENTER RIVERSIDE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2018
Last Update Date: 06/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3495 JEFFERSON ST
RIVERSIDE CA
92504-3519
US

IV. Provider business mailing address

27525 PUERTA REAL # 100-141
MISSION VIEJO CA
92691-6379
US

V. Phone/Fax

Practice location:
  • Phone: 951-763-7904
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. MALIK SHARIF
Title or Position: CFO
Credential:
Phone: 949-629-8872