ST. JOSEPH HEALTH SYSTEM HOME CARE SERVICES LLC NPI 1457772675

NPI Information

NPI: 1457772675
Provider Name: ST. JOSEPH HEALTH SYSTEM HOME CARE SERVICES LLC

Doing Business As: ST. MARY HIGH DESERT HOSPICE

Classification: Hospice Care, Community Based - 251G00000X
Entity Type: Organization

CLIA Number: 05D2082102

Address:
8560 VINEYARD AVE STE 516
RANCHO CUCAMONGA, CA
ZIP 91730
Phone: (909) 728-2801
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ST. JOSEPH HEALTH SYSTEM HOME CARE SERVICES LLC is a hospice care community based in Rancho Cucamonga, CA. ST. JOSEPH HEALTH SYSTEM HOME CARE SERVICES LLC NPI is 1457772675. The provider is registered as an organization entity type.
The provider Is Doing Business As St. Mary High Desert Hospice.

The provider's business location address is:

8560 VINEYARD AVE STE 516
RANCHO CUCAMONGA, CA
ZIP 91730-350
Phone: (909) 728-2801
Fax: (909) 292-4512

The provider's authorized official is Donald Wayne Anderson .
The authorized official title is Assistant Secretary For Enrollment and has the following contact phone number (425) 525-5392.

The CLIA number assigned to this NPI record is 05D2082102 - hospice with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/16/2013 and was last updated on 9/21/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	251G00000X	Hospice Care, Community Based				Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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