MEDICARE: LIFELINK HOSPICE & PALLIATIVE CARE, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1154766301
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIFELINK HOSPICE & PALLIATIVE CARE, INC.

Provider Business Mailing Address
First Line	:	211 W FOOTHILL BLVD STE B
Second Line	:
City	:	GLENDORA
State	:	CA
Zip	:	91741-3357
Country	:	US
Telephone Number	:	626-335-6173
Fax Number	:	626-387-9651

Provider Business Practice Location Address
First Line	:	211 W FOOTHILL BLVD STE B
Second Line	:
City	:	GLENDORA
State	:	CA
Zip	:	91741-3357
Country	:	US
Telephone Number	:	626-335-6173
Fax Number	:	626-387-9651

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. ROSARIO VALENCIANO-SISON
Credential	:
Telephone Number	:	626-335-6173

Provider Enumeration Date	:	05/01/2013
Last Update Date	:	03/07/2018

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