MEDICARE: INLAND VALLEY HOSPICE 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	:	1376765834
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INLAND VALLEY HOSPICE CARE,INC

Provider Business Mailing Address
First Line	:	15366 11TH ST STE O
Second Line	:
City	:	VICTORVILLE
State	:	CA
Zip	:	92395-3726
Country	:	US
Telephone Number	:	760-243-2501
Fax Number	:	760-243-5527

Provider Business Practice Location Address
First Line	:	15366 11TH ST STE O
Second Line	:
City	:	VICTORVILLE
State	:	CA
Zip	:	92395-3726
Country	:	US
Telephone Number	:	760-243-2501
Fax Number	:	760-243-5527

Authorized Official
Title or Position	:	PRESIDENT
Name	:	NATALIE ROSE ALLEN
Credential	:
Telephone Number	:	760-243-2501

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	02/17/2010

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Directions to “INLAND VALLEY HOSPICE CARE,INC ” Practice Location

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