Organization Name: | FOOTHILL HOSPICE CARE INC |
NPI Number: | 1043628217 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ROZA DAVITIAN (CEO) |
Mailing Address: | 222 N Mountain Ave Ste 207 Upland |
State: | CA US |
Postal Code: | 917865745 |
Phone Number: | 9099192535 |
Fax Number: | 9099192574 |
NPI Enumeration Date: | 07/31/2014 |
NPI Last Update Date: | 07/31/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251G00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Hospice Care, Community Based |
Taxonomy Specialization: | |
Taxonomy Definition: |