Provider Demographics
NPI:1902017684
Name:COMMUNITY HOSPICE SERVICES, INC.
Entity Type:Organization
Organization Name:COMMUNITY HOSPICE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ZENAIDA
Authorized Official - Middle Name:QUINONES
Authorized Official - Last Name:HAPA-BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:909-477-6795
Mailing Address - Street 1:8273 WHITE OAK AVE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-7671
Mailing Address - Country:US
Mailing Address - Phone:909-477-6795
Mailing Address - Fax:909-477-6794
Practice Address - Street 1:8273 WHITE OAK AVE
Practice Address - Street 2:SUITE 120
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-7671
Practice Address - Country:US
Practice Address - Phone:909-477-6795
Practice Address - Fax:909-477-6794
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA551515Medicare Oscar/Certification