Provider Demographics
NPI:1760004147
Name:LADY OF JOY HOSPICE INC
Entity Type:Organization
Organization Name:LADY OF JOY HOSPICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VERNA
Authorized Official - Middle Name:E
Authorized Official - Last Name:MON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-222-6960
Mailing Address - Street 1:4259 PALO VERDE STREET
Mailing Address - Street 2:SUITE 103A-6
Mailing Address - City:MONTCLAIR
Mailing Address - State:CA
Mailing Address - Zip Code:91763-2302
Mailing Address - Country:US
Mailing Address - Phone:909-222-6960
Mailing Address - Fax:909-236-5613
Practice Address - Street 1:4259 PALO VERDE STREET
Practice Address - Street 2:SUITE 103A-6
Practice Address - City:MONTCLAIR
Practice Address - State:CA
Practice Address - Zip Code:91763-2302
Practice Address - Country:US
Practice Address - Phone:909-222-6960
Practice Address - Fax:909-236-5613
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-08
Last Update Date:2020-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based