Provider Demographics
NPI:1760145817
Name:SILVERADO HOSPICE SAN BERNARDINO, INC.
Entity Type:Organization
Organization Name:SILVERADO HOSPICE SAN BERNARDINO, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SWEETSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-240-7200
Mailing Address - Street 1:6400 OAK CYN STE 200
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-5233
Mailing Address - Country:US
Mailing Address - Phone:949-240-7200
Mailing Address - Fax:949-705-4985
Practice Address - Street 1:125 W SIERRA MADRE AVE
Practice Address - Street 2:
Practice Address - City:AZUSA
Practice Address - State:CA
Practice Address - Zip Code:91702-2023
Practice Address - Country:US
Practice Address - Phone:949-240-7200
Practice Address - Fax:949-705-4985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-15
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based