Organization
EAGEL TIME CARE FACILITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JUAN CORNELL (ADMINISTRATOR)
(562) 685-4610
Entity
Organization
Contact information
Practice address
1622 PALERMO DR, RIVERSIDE, CA 92507-2393
(562) 685-4610
Mailing address
1622 PALERMO DR, RIVERSIDE, CA 92507-2393
(951) 848-7441
Taxonomy
Speciality
Code
Description
License number
State
177F00000X
Lodging Provider
Primary
—
—
Other
Enumeration date
12/23/2021
Last updated
09/22/2022
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