Provider Demographics
NPI:1679152755
Name:DESERT PALM HOSPICE INC
Entity Type:Organization
Organization Name:DESERT PALM HOSPICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:REYNALDO
Authorized Official - Middle Name:
Authorized Official - Last Name:DE LA CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-506-3703
Mailing Address - Street 1:28751 RANCHO CALIFORNIA RD STE 202
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92590-1865
Mailing Address - Country:US
Mailing Address - Phone:951-506-3703
Mailing Address - Fax:951-506-3700
Practice Address - Street 1:28751 RANCHO CALIFORNIA RD STE 202
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-1865
Practice Address - Country:US
Practice Address - Phone:951-506-3703
Practice Address - Fax:951-506-3700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-06
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based