Provider Demographics
NPI:1366848863
Name:INFINITY HOSPICE PROVIDERS INC
Entity Type:Organization
Organization Name:INFINITY HOSPICE PROVIDERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CANLAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-296-1200
Mailing Address - Street 1:876 N MOUNTAIN AVE
Mailing Address - Street 2:STE 200P
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-4166
Mailing Address - Country:US
Mailing Address - Phone:909-296-1200
Mailing Address - Fax:909-543-0841
Practice Address - Street 1:876 N MOUNTAIN AVE
Practice Address - Street 2:STE 200P
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-4166
Practice Address - Country:US
Practice Address - Phone:909-296-1200
Practice Address - Fax:909-543-0841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-10
Last Update Date:2014-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based