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
1	251V00000X	Voluntary or Charitable Agency

General Provider Information

NPI Number	:	1821193954
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	:	6711 ARLINGTON AVENUE
Second Line	:	STE ABCD
City	:	RIVERSIDE
State	:	CA
Zip	:	92504-1955
Country	:	US
Telephone Number	:	951-352-4964
Fax Number	:	951-352-4965

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	DR. JASON CARL JIMENEZ
Credential	:
Telephone Number	:	909-379-9680

Provider Enumeration Date	:	09/13/2006
Last Update Date	:	09/22/2025

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