# BROADWATER ONTARIO CARE CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Ontario Healthcare Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316080260
- **Authorized official:** DOUGLAS EASTON (MANAGER)
- **Authorized official phone:** (818) 368-1862

## Contact information

- **Practice address:** 1661 S EUCLID AVE, ONTARIO, CA 91762-5826
- **Practice address phone:** (909) 984-6713
- **Practice address fax:** (909) 984-5254
- **Mailing address:** 1661 S EUCLID AVE, ONTARIO, CA 91762-5826
- **Mailing address phone:** (909) 984-6713
- **Mailing address fax:** (909) 984-5254

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 240000181 | CA | Yes |

## Other

- **Enumeration date:** 02/14/2007
- **Last updated:** 06/09/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1316080260 | — | CA |