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General NPI Number Information
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NPI Number | 1972909596
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Entity Type | Organization
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Legal Business Name | IVY HOSPICE CARE, INC.
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Dates
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Enumeration Date | 11/10/2014
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Last Update Date | 11/21/2022
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Provider Practice Location Address
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Address Line | 545 N MOUNTAIN AVE STE 101
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City | UPLAND
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State | CA
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Zip | 91786-5054
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Country | US
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Telephone | 909-931-5090
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Fax | 909-931-5908
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Provider Business Mailing Address
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Address Line | 545 N MOUNTAIN AVE STE 101
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City | UPLAND
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State | CA
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Zip | 91786-5054
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Country | US
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Telephone | 909-931-5090
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Fax | 909-931-5908
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Authorized Official
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Title or Position | PRESIDENT/CEO & ADMINISTRATOR
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Name | MARGARITA SANTIAGO ARCILLA
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Credential |
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Telephone | 909-931-5090
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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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