MEDICARE: HOSPICE SOLACE, 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	:	1982236048
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOSPICE SOLACE, INC.

Provider Business Mailing Address
First Line	:	24616 LAWTON AVE
Second Line	:
City	:	LOMA LINDA
State	:	CA
Zip	:	92354-3324
Country	:	US
Telephone Number	:	909-317-1520
Fax Number	:

Provider Business Practice Location Address
First Line	:	720 BROOKSIDE AVE STE 104
Second Line	:
City	:	REDLANDS
State	:	CA
Zip	:	92373-5189
Country	:	US
Telephone Number	:	909-317-1520
Fax Number	:

Authorized Official
Title or Position	:	DPCS/ADMINISTRATOR
Name	:	TIARA J ZALSOS
Credential	:	RN
Telephone Number	:	909-317-1520

Provider Enumeration Date	:	02/06/2020
Last Update Date	:	02/06/2020

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Directions to “HOSPICE SOLACE, INC. ” Practice Location

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