# CRESTVIEW CONVALESCENT HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255340592
- **Authorized official:** ROY V BERGLUND MD (OWNER)
- **Authorized official phone:** (909) 877-1361

## Contact information

- **Practice address:** 1471 S RIVERSIDE AVE, RIALTO, CA 92376-7703
- **Practice address phone:** (909) 877-0854
- **Mailing address:** 1471 S RIVERSIDE AVE, RIALTO, CA 92376-7703
- **Mailing address phone:** (909) 877-0854

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 240000134 | CA | Yes |

## Other

- **Enumeration date:** 08/05/2006
- **Last updated:** 04/25/2008