Provider Demographics
NPI:1821766023
Name:REVEREND HOSPICE INC
Entity Type:Organization
Organization Name:REVEREND HOSPICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALMONTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-513-4116
Mailing Address - Street 1:26459 SEVILLE LN
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-6116
Mailing Address - Country:US
Mailing Address - Phone:909-571-0040
Mailing Address - Fax:
Practice Address - Street 1:275 W HOSPITALITY LN STE 302E
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-3265
Practice Address - Country:US
Practice Address - Phone:909-571-0040
Practice Address - Fax:909-575-3681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-01
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based