# CLOVERLEAF ENTERPRISE INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Cherry Valley Healthcare
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255312831
- **Authorized official:** MR. ANTHONY ALBERT LOPEZ NHA (ADMINISTRATOR)
- **Authorized official phone:** (951) 845-1606

## Contact information

- **Practice address:** 5800 W WILSON ST, BANNING, CA 92220-3042
- **Practice address phone:** (951) 845-1606
- **Practice address fax:** (951) 845-4152
- **Mailing address:** 5800 W WILSON ST, BANNING, CA 92220-3042
- **Mailing address phone:** (951) 845-1606
- **Mailing address fax:** (951) 845-4152

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 250000298 | CA | Yes |

## Other

- **Enumeration date:** 11/09/2005
- **Last updated:** 03/30/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | LTC55309G | — | CA |