Healthcare Provider Details

I. General information

NPI: 1376458216
Provider Name (Legal Business Name): LEVELUP ASSISTED LIVING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3667 BROADMOOR BLVD
SAN BERNARDINO CA
92404-1709
US

IV. Provider business mailing address

3667 BROADMOOR BLVD
SAN BERNARDINO CA
92404-1709
US

V. Phone/Fax

Practice location:
  • Phone: 909-882-2723
  • Fax:
Mailing address:
  • Phone: 909-882-2723
  • Fax: 909-882-2723

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: GRACE YANG
Title or Position: MANAGING MEMBER
Credential: RN, BSN
Phone: 909-882-2723