Organization
SOUTH COAST HEALTH & WELLNESS CORPORATION
Active
Other names
Community Care on Palm
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHERYL JUMONVILLE (PRESIDENT/OWNER)
(951) 686-9001
Entity
Organization
Contact information
Practice address
4768 PALM AVE, RIVERSIDE, CA 92501-4012
(951) 686-9001
(951) 686-0148
Mailing address
4768 PALM AVE, RIVERSIDE, CA 92501-4012
(951) 686-9001
(951) 686-0148
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
250000115
CA
314000000X
Skilled Nursing Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LTC55711H
—
CA
Enumeration date
07/11/2006
Last updated
01/21/2020
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