Provider Demographics
NPI:1609447002
Name:HOSPICE FOR LOMA LINDA
Entity Type:Organization
Organization Name:HOSPICE FOR LOMA LINDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CEL
Authorized Official - Middle Name:ARDEN
Authorized Official - Last Name:ZALSOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-513-9934
Mailing Address - Street 1:1457 EDELWEISS DR UNIT C
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:CA
Mailing Address - Zip Code:92223-3377
Mailing Address - Country:US
Mailing Address - Phone:909-513-9934
Mailing Address - Fax:
Practice Address - Street 1:24674 REDLANDS BLVD
Practice Address - Street 2:
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-4019
Practice Address - Country:US
Practice Address - Phone:909-513-9934
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-07
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based