Cloverleaf Enterprises, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

CLOVERLEAF ENTERPRISES, INC.

Doing business as

Banning Healthcare

Practice address

3476 W Wilson St
Banning, CA 92220-3420

Phone

(951) 849-4723

Fax

(951) 849-0972

NPI assigned

Nov 9, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Mario I Bertumen Sr., NHA

Title

Administrator

Phone

(951) 849-4723

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Banning Healthcare Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356322937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3476 W WILSON ST",
            "city": "BANNING",
            "state": "CA",
            "postal_code": "922203420",
            "telephone_number": "951-849-4723",
            "fax_number": "951-849-0972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3476 W WILSON ST",
            "city": "BANNING",
            "state": "CA",
            "postal_code": "922203420",
            "telephone_number": "951-849-4723",
            "fax_number": "951-849-0972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLOVERLEAF ENTERPRISES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BERTUMEN",
        "authorized_official_first_name": "MARIO",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "951-849-4723",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "NHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC55319G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Banning Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ludwig J Cibelli, M.D
• City of Banning
• Trence Clark, M.D
• Pascale A Claus, LPCC
• Cloverleaf Enterprise Inc (Cherry Valley Healthcare)
• Daniel Wayne Cobb, SCHOOL COUNSELING
• James Cockerham
• Emily Cole
• Comfort Measure, Inc
• Sandra H Conley, R.N.

• Skilled Nursing Facility in Banning, CA
• Providers in Banning, CA by specialty
• Skilled Nursing Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.