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General NPI Number Information
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NPI Number | 1306827415
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Entity Type | Organization
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Legal Business Name | ROYAL CONVALESCENT HOSPITAL INC.
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Dates
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Enumeration Date | 11/07/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 320 CATTLE CALL DR
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City | BRAWLEY
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State | CA
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Zip | 92227-3108
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Country | US
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Telephone | 760-344-5431
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Fax | 760-344-8240
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Provider Business Mailing Address
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Address Line | 320 CATTLE CALL DR
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City | BRAWLEY
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State | CA
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Zip | 92227-3108
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Country | US
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Telephone | 760-344-5431
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Fax | 760-344-8240
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. FRED FRIEDMAN
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Credential |
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Telephone | 760-344-5431
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | ZZT05893G
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License Number State | CA
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