Provider Demographics
NPI:1083959498
Name:REDLANDS HOSPICE CARE, INC.
Entity Type:Organization
Organization Name:REDLANDS HOSPICE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CEL ARDEN
Authorized Official - Middle Name:DOROTHEO
Authorized Official - Last Name:ZALSOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-482-4256
Mailing Address - Street 1:720 BROOKSIDE AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-5189
Mailing Address - Country:US
Mailing Address - Phone:909-335-3500
Mailing Address - Fax:909-801-2088
Practice Address - Street 1:720 BROOKSIDE AVE STE 102
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-5189
Practice Address - Country:US
Practice Address - Phone:909-335-3500
Practice Address - Fax:909-801-2088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-11
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550002216251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA551746Medicare Oscar/Certification