Provider Demographics
NPI:1376060764
Name:WETHERBY HOSPICE CARE, INC.
Entity Type:Organization
Organization Name:WETHERBY HOSPICE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-999-6186
Mailing Address - Street 1:1365 W FOOTHILL BLVD STE 6
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-3612
Mailing Address - Country:US
Mailing Address - Phone:909-999-6186
Mailing Address - Fax:909-999-6756
Practice Address - Street 1:1365 W FOOTHILL BLVD STE 6
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-3612
Practice Address - Country:US
Practice Address - Phone:909-999-6186
Practice Address - Fax:909-999-6756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based