# COMMUNITY CARE ON PALM RIVERSIDE, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Community Care on Palm
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619560216
- **Authorized official:** EZRA BERCOVICH (MANAGER)
- **Authorized official phone:** (213) 948-0193

## Contact information

- **Practice address:** 4768 PALM AVE, RIVERSIDE, CA 92501-4012
- **Practice address phone:** (951) 686-9001
- **Practice address fax:** (951) 367-0167
- **Mailing address:** 1515 N FAIR OAKS AVE, PASADENA, CA 91103-1808
- **Mailing address phone:** (951) 686-9001
- **Mailing address fax:** (951) 367-0167

## Taxonomy

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

## Other

- **Enumeration date:** 02/15/2021
- **Last updated:** 02/15/2021