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NPI Code Detail

MEDICARE: C.H.A.R.L.E.E. FAMILY CARE, INC.

MEDICARE: C.H.A.R.L.E.E. FAMILY CARE, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251V00000XVoluntary or Charitable Agency

General Provider Information

NPI Number : 1366773210
Entity Type Code : Organization
Provider Name (Legal Business Name) : C.H.A.R.L.E.E. FAMILY CARE, INC.
Provider Business Mailing Address
First Line : 136 E 6TH STREET
Second Line :
City : BEAUMONT
State : CA
Zip : 92223-2146
Country : US
Telephone Number : 951-845-3588
Fax Number : 951-845-3544
Provider Business Practice Location Address
First Line : 25190 HANCOCK AVENUE
Second Line : STE D
City : MURRIETA
State : CA
Zip : 92562-5984
Country : US
Telephone Number : 951-239-8280
Fax Number : 951-239-8284
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : DR. JASON CARL JIMENEZ
Credential :
Telephone Number : 909-379-9680
Provider Enumeration Date : 01/15/2010
Last Update Date : 09/22/2025

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