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General NPI Number Information
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NPI Number | 1801749064
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Entity Type | Organization
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Legal Business Name | VITALBREATH CARE FACILITY LLC
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Dates
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Enumeration Date | 02/18/2026
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Last Update Date | 02/18/2026
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Provider Practice Location Address
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Address Line | 7817 SAUTERNE DR
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-2410
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Country | US
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Telephone | 714-745-2896
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Fax |
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Provider Business Mailing Address
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Address Line | 6876 RIPPLE CT
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City | JURUPA VALLEY
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State | CA
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Zip | 91752-2749
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Country | US
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Telephone | 714-745-2896
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JIMMY LU
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Credential |
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Telephone | 714-745-2896
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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 |
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License Number State |
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