| Organization Name: | IMMANUEL HOSPICE, INC. |
| NPI Number: | 1669607651 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHAEL L. FOLKES (ADMINISTRATOR) |
| Mailing Address: | 482 W. Arrow Hwy Suite G San Dimas |
| State: | CA US |
| Postal Code: | 917732960 |
| Phone Number: | 9095924834 |
| Fax Number: | 9095921708 |
| NPI Enumeration Date: | 05/20/2009 |
| NPI Last Update Date: | 05/20/2009 |
| 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: | |