Healthcare Provider Details

I. General information

NPI: 1336788058
Provider Name (Legal Business Name): CALCARE HOSPICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2019
Last Update Date: 03/26/2023
Certification Date: 03/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 N MOUNTAIN AVE STE 214-B
UPLAND CA
91786-5714
US

IV. Provider business mailing address

2331 W LINCOLN AVE STE 100
ANAHEIM CA
92801-5103
US

V. Phone/Fax

Practice location:
  • Phone: 909-931-0644
  • Fax: 909-579-2167
Mailing address:
  • Phone: 714-349-6082
  • Fax: 909-579-2167

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: MARK ANTHONY BAUTISTA MESIAS
Title or Position: CEO
Credential:
Phone: 909-931-0644