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General NPI Number Information
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NPI Number | 1619294899
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Entity Type | Organization
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Legal Business Name | RAMONA MANOR CONVALESCENT HOSPITAL
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Dates
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Enumeration Date | 04/27/2010
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Last Update Date | 04/27/2010
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Provider Practice Location Address
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Address Line | 485 W JOHNSTON AVE
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City | HEMET
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State | CA
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Zip | 92543-7012
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Country | US
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Telephone | 951-652-0011
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Fax | 951-658-1457
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Provider Business Mailing Address
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Address Line | 485 W JOHNSTON AVE
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City | HEMET
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State | CA
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Zip | 92543-7012
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Country | US
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Telephone | 951-652-0011
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Fax | 951-658-1457
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. MARK MILLER
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Credential |
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Telephone | 951-652-0011
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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 | 250000190
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License Number State | CA
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