Provider Demographics
NPI:1467036202
Name:PRISTINE HOSPICE CARE PLUS, INC.
Entity Type:Organization
Organization Name:PRISTINE HOSPICE CARE PLUS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BERNICE
Authorized Official - Middle Name:
Authorized Official - Last Name:IVOKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-999-5088
Mailing Address - Street 1:9087 ARROW RTE STE 280
Mailing Address - Street 2:
Mailing Address - City:RCH CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-4478
Mailing Address - Country:US
Mailing Address - Phone:909-999-5088
Mailing Address - Fax:909-999-5087
Practice Address - Street 1:9087 ARROW RTE STE 284
Practice Address - Street 2:
Practice Address - City:RCH CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-4478
Practice Address - Country:US
Practice Address - Phone:909-999-5088
Practice Address - Fax:909-999-5087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-07
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based