PACIFIC CREST HOSPICE OF THE HIGH DESERT LLC NPI 1396409561

NPI Information

PACIFIC CREST HOSPICE OF THE HIGH DESERT LLC is a hospice care community based in Victorville, CA. PACIFIC CREST HOSPICE OF THE HIGH DESERT LLC NPI is 1396409561. The provider is registered as an organization entity type.

The provider's business location address is:

13300 11TH STREET
VICTORVILLE, CA
ZIP 92395
Phone: (760) 808-2646

The provider's authorized official is Jose Lynch .
The authorized official title is Managing Member and has the following contact phone number (714) 673-6810.

The CLIA number assigned to this NPI record is 05D2258561 - hospice with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/25/2021 and was last updated on 12/14/2021.

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:

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