Organization
BRASWELLS HAMPTON MANOR LP
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
11970 4TH ST, YUCAIPA, CA 92399-2720
(909) 790-2273
(909) 790-3333
Mailing address
11970 4TH ST, YUCAIPA, CA 92399-2720
(909) 790-2273
(909) 790-3333
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LTC55494F
—
CA
Enumeration date
02/01/2006
Last updated
08/22/2020
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