Provider Demographics
NPI:1003586355
Name:IE HOSPICE SERVICES ,LLC
Entity Type:Organization
Organization Name:IE HOSPICE SERVICES ,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CLIFFORD
Authorized Official - Middle Name:R
Authorized Official - Last Name:VILLAFLOR
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:909-579-8237
Mailing Address - Street 1:19326 EMPTY SADDLE RD
Mailing Address - Street 2:
Mailing Address - City:WALNUT
Mailing Address - State:CA
Mailing Address - Zip Code:91789-4285
Mailing Address - Country:US
Mailing Address - Phone:626-272-2754
Mailing Address - Fax:
Practice Address - Street 1:8333 FOOTHILL BLVD STE 111
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-3155
Practice Address - Country:US
Practice Address - Phone:909-579-8237
Practice Address - Fax:626-236-4146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-17
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based