# IMMACULATE CARE CENTER INC.

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

## Provider details

- **NPI number:** 1649442831
- **Authorized official:** MS. DORYCE M. AGUIRRE RASI (SUPERVISOR)
- **Authorized official phone:** (951) 243-0303

## Contact information

- **Practice address:** 24384 SUNNYMEAD BLVD STE.240, MORENO VALLEY, CA 92553
- **Practice address phone:** (951) 243-0303
- **Practice address fax:** (951) 243-3006
- **Mailing address:** 24384 SUNNYMEAD BLVD STE 240, MORENO VALLEY, CA 92553-7765
- **Mailing address phone:** (951) 243-0303
- **Mailing address fax:** (951) 243-3006

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | — | NULL | Yes |

## Other

- **Enumeration date:** 03/27/2008
- **Last updated:** 03/27/2008