MEDICARE: SOLIDARITY 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	:	1376925925
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOLIDARITY HOSPICE CARE, INC.

Provider Business Mailing Address
First Line	:	1224 E KATELLA AVE
Second Line	:	SUITE 101
City	:	ORANGE
State	:	CA
Zip	:	92867-5049
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1224 E KATELLA AVE
Second Line	:	SUITE 101
City	:	ORANGE
State	:	CA
Zip	:	92867-5049
Country	:	US
Telephone Number	:	714-386-6180
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CHRISTINE RONQUILLO
Credential	:
Telephone Number	:	714-386-6180

Provider Enumeration Date	:	06/19/2015
Last Update Date	:	06/19/2015

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