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General NPI Number Information
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NPI Number | 1467036202
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Entity Type | Organization
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Legal Business Name | PRISTINE HOSPICE CARE PLUS, INC.
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Dates
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Enumeration Date | 05/07/2021
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Last Update Date | 05/07/2021
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Provider Practice Location Address
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Address Line | 9087 ARROW RTE STE 284
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City | RCH CUCAMONGA
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State | CA
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Zip | 91730-4478
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Country | US
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Telephone | 909-999-5088
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Fax | 909-999-5087
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Provider Business Mailing Address
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Address Line | 9087 ARROW RTE STE 280
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City | RCH CUCAMONGA
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State | CA
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Zip | 91730-4478
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Country | US
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Telephone | 909-999-5088
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Fax | 909-999-5087
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Authorized Official
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Title or Position | CEO
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Name | BERNICE IVOKO
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Credential |
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Telephone | 909-999-5088
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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