Healthcare Provider Details

I. General information

NPI: 1447248075
Provider Name (Legal Business Name): ARROWHEAD HOME CONVALESCENT HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4343 N SIERRA WAY
SAN BERNARDINO CA
92407-3822
US

IV. Provider business mailing address

4343 N SIERRA WAY
SAN BERNARDINO CA
92407-3822
US

V. Phone/Fax

Practice location:
  • Phone: 909-887-4731
  • Fax: 909-886-8399
Mailing address:
  • Phone: 909-887-4731
  • Fax: 909-886-8399

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. DON POPOVICH
Title or Position: ADMINISTRATOR
Credential:
Phone: 909-886-4731