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Organization
BRASWELLS YUCAIPA VALLEY CONVALESCENT LP
Active
Organization
BRASWELLS YUCAIPA VALLEY CONVALESCENT LP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. VALERIE CANDELARIA (DIRECTOR OF AR)
(909) 446-8754
Entity
Organization
Contact information
Practice address
35253 AVENUE H, YUCAIPA, CA 92399-5415
(909) 795-2476
(909) 795-0458
Mailing address
35253 AVENUE H, YUCAIPA, CA 92399-5415
(909) 795-2476
(909) 795-0458
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
055557
MEDICARE PROVIDER NUMBER
CA
05
—
ZZT05557G
—
CA
Enumeration date
02/01/2006
Last updated
07/16/2007
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