Healthcare Provider Details

I. General information

NPI: 1508736703
Provider Name (Legal Business Name): BMORENTERPRISE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/11/2025
Last Update Date: 11/11/2025
Certification Date: 11/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3264 N H ST
SAN BERNARDINO CA
92405-2861
US

IV. Provider business mailing address

3264 N H ST
SAN BERNARDINO CA
92405-2861
US

V. Phone/Fax

Practice location:
  • Phone: 909-527-9782
  • Fax:
Mailing address:
  • Phone: 909-527-9782
  • Fax:

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: BRITTANY ACOSTA
Title or Position: OWNER/OPERATED
Credential:
Phone: 909-527-9782