Provider Demographics
NPI:1255862389
Name:JOURNEY HOSPICE CARE INC.
Entity Type:Organization
Organization Name:JOURNEY HOSPICE CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JASMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:AVILA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-399-3945
Mailing Address - Street 1:5050 PALO VERDE ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:MONTCLAIR
Mailing Address - State:CA
Mailing Address - Zip Code:91763-2329
Mailing Address - Country:US
Mailing Address - Phone:909-399-3945
Mailing Address - Fax:
Practice Address - Street 1:5050 PALO VERDE ST
Practice Address - Street 2:SUITE 205
Practice Address - City:MONTCLAIR
Practice Address - State:CA
Practice Address - Zip Code:91763-2329
Practice Address - Country:US
Practice Address - Phone:909-399-3945
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-21
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based