Organization
BRASWELL'S COMMUNITY CONVALESCENT LTD
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
13542 2ND ST, YUCAIPA, CA 92399-5396
(909) 795-2421
(909) 795-5939
Mailing address
13542 2ND ST, YUCAIPA, CA 92399-5396
(909) 795-2421
(909) 795-5939
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
240000236
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
056365
MEDICARE PROVIDER NUMBER
CA
05
—
ZZT18152G
—
CA
Enumeration date
02/01/2006
Last updated
06/06/2008
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