Provider Demographics
NPI:1922693142
Name:PHILCARE HOSPICE INC
Entity Type:Organization
Organization Name:PHILCARE HOSPICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TOBY
Authorized Official - Middle Name:
Authorized Official - Last Name:MICLAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-408-8996
Mailing Address - Street 1:359 W LANGSTON ST
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-3128
Mailing Address - Country:US
Mailing Address - Phone:714-408-8996
Mailing Address - Fax:
Practice Address - Street 1:1120 BRIARCROFT RD
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-3211
Practice Address - Country:US
Practice Address - Phone:714-408-8996
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-09
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient