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General NPI Number Information
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NPI Number | 1932454360
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Entity Type | Organization
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Legal Business Name | LIGHTHOUSE HOSPICE CARE INC
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Dates
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Enumeration Date | 07/23/2012
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Last Update Date | 06/04/2013
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Provider Practice Location Address
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Address Line | 10535 FOOTHILL BLVD STE 408
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-3829
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Country | US
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Telephone | 909-989-8884
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Fax | 909-989-8834
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Provider Business Mailing Address
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Address Line | 1763 JUNE LN
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City | GLENDALE
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State | CA
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Zip | 91208-2315
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Country | US
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Telephone | 909-989-8884
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Fax | 909-989-8834
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Authorized Official
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Title or Position | CFO
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Name | LILIBETH SIOSON SAN GABRIEL
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Credential | RN
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Telephone | 909-989-8884
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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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