=====================================================
General NPI Number Information
=====================================================
NPI Number | 1902017916
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PEOPLES CARE HOSPICE, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/24/2007
-----------------------------------------------------
Last Update Date | 01/21/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 13920 CITY CENTER DR SUITE 230 A
-----------------------------------------------------
City | CHINO HILLS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91709-5432
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 909-203-7999
-----------------------------------------------------
Fax | 909-287-3485
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 13920 CITY CENTER DR SUITE 230 A
-----------------------------------------------------
City | CHINO HILLS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91709-5432
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 909-203-7999
-----------------------------------------------------
Fax | 909-287-3485
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO/PRESIDENT
-----------------------------------------------------
Name | MR. MICHAEL J KAISER
-----------------------------------------------------
Credential | RN
-----------------------------------------------------
Telephone | 626-665-1080
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251G00000X
-----------------------------------------------------
Taxonomy Name | Community Based Hospice Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 251G00000X
-----------------------------------------------------
Taxonomy Name | Community Based Hospice Care Agency
-----------------------------------------------------
License Number | 550000963
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------