Provider Demographics
NPI:1639525272
Name:GOOD SHEPHERD HOSPICE, LLC
Entity Type:Organization
Organization Name:GOOD SHEPHERD HOSPICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOE CAMILLE
Authorized Official - Middle Name:J
Authorized Official - Last Name:ESPINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-400-5768
Mailing Address - Street 1:270 E 7TH ST STE 1B
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-6602
Mailing Address - Country:US
Mailing Address - Phone:909-608-0000
Mailing Address - Fax:909-608-0003
Practice Address - Street 1:270 E 7TH ST STE 1B
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-6602
Practice Address - Country:US
Practice Address - Phone:909-608-0000
Practice Address - Fax:909-608-0003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-13
Last Update Date:2016-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based