Healthcare Provider Details

I. General information

NPI: 1578168365
Provider Name (Legal Business Name): PEACEFUL JOURNEY HOSPICE CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2020
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11030 ARROW RTE STE 203B
RANCHO CUCAMONGA CA
91730-4837
US

IV. Provider business mailing address

11030 ARROW RTE STE 203B
RANCHO CUCAMONGA CA
91730-4837
US

V. Phone/Fax

Practice location:
  • Phone: 626-313-3131
  • Fax:
Mailing address:
  • Phone: 626-313-3131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: JAHZEEL TIAMSON
Title or Position: CEO
Credential:
Phone: 626-800-0114