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General NPI Number Information
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NPI Number | 1558937201
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Entity Type | Organization
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Legal Business Name | SHINING LIGHT HOSPICE CARE INC
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Dates
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Enumeration Date | 06/02/2021
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Last Update Date | 06/02/2021
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Provider Practice Location Address
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Address Line | 222 N MOUNTAIN AVE STE 201B
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City | UPLAND
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State | CA
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Zip | 91786-5714
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Country | US
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Telephone | 909-694-2788
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Fax |
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Provider Business Mailing Address
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Address Line | 222 N MOUNTAIN AVE STE 201B
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City | UPLAND
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State | CA
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Zip | 91786-5714
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Country | US
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Telephone | 909-694-2788
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MISS LYN ANNE ESCANO
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Credential |
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Telephone | 909-694-2788
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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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