# CLOVERLEAF ENTERPRISES, INC.

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

## Provider details

- **NPI number:** 1356322937
- **Authorized official:** MR. MARIO I BERTUMEN SR. NHA (ADMINISTRATOR)
- **Authorized official phone:** (951) 849-4723

## Contact information

- **Practice address:** 3476 W WILSON ST, BANNING, CA 92220-3420
- **Practice address phone:** (951) 849-4723
- **Practice address fax:** (951) 849-0972
- **Mailing address:** 3476 W WILSON ST, BANNING, CA 92220-3420
- **Mailing address phone:** (951) 849-4723
- **Mailing address fax:** (951) 849-0972

## Taxonomy

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

## Other

- **Enumeration date:** 11/09/2005
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | LTC55319G | — | CA |