Healthcare Provider Details

I. General information

NPI: 1528517141
Provider Name (Legal Business Name): HOME PALLIATIVE CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2016
Last Update Date: 11/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

527 E ROWLAND ST STE 201
COVINA CA
91723
US

IV. Provider business mailing address

31250 HIGHLAND AVE
REDLANDS CA
92374-8260
US

V. Phone/Fax

Practice location:
  • Phone: 800-843-1778
  • Fax:
Mailing address:
  • Phone: 800-743-1778
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: NICHOLAS SILAO
Title or Position: EXECUTIVE DIRECTOR
Credential: RN, CRNA, MA
Phone: 800-843-1778