Healthcare Provider Details

I. General information

NPI: 1992995781
Provider Name (Legal Business Name): CHAPMAN HOSPICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2007
Last Update Date: 08/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6736 PALM AVENUE
RIVERSIDE CA
92506
US

IV. Provider business mailing address

4301 CAROLINE CT
RIVERSIDE CA
92506-2902
US

V. Phone/Fax

Practice location:
  • Phone: 951-784-1388
  • Fax: 951-683-6826
Mailing address:
  • Phone: 951-683-7111
  • Fax: 951-683-6826

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number250000124
License Number StateCA

VIII. Authorized Official

Name: MRS. TRACY TANNER
Title or Position: COO
Credential:
Phone: 951-683-7111