MEDICARE: ARROWHEAD HEALTHCARE CENTER LLC

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
1	314000000X	Skilled Nursing Facility	240000109	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659768406
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARROWHEAD HEALTHCARE CENTER LLC

Provider Business Mailing Address
First Line	:	4343 N SIERRA WAY
Second Line	:
City	:	SAN BERNARDINO
State	:	CA
Zip	:	92407-3822
Country	:	US
Telephone Number	:	909-886-4731
Fax Number	:	909-886-8399

Provider Business Practice Location Address
First Line	:	4343 N SIERRA WAY
Second Line	:
City	:	SAN BERNARDINO
State	:	CA
Zip	:	92407-3822
Country	:	US
Telephone Number	:	909-886-4731
Fax Number	:	909-886-8399

Authorized Official
Title or Position	:	CEO
Name	:	CRYSTAL SOLORZANO
Credential	:
Telephone Number	:	323-836-9397

Provider Enumeration Date	:	04/20/2015
Last Update Date	:	07/26/2022

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