Provider Demographics
NPI:1972129641
Name:CARDINAL HOSPICE AND PALLIATIVE CARE
Entity Type:Organization
Organization Name:CARDINAL HOSPICE AND PALLIATIVE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GLODILYN
Authorized Official - Middle Name:BADILLA
Authorized Official - Last Name:MANCILLA-ALMARIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-529-3138
Mailing Address - Street 1:500 N PALM AVE
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91762-3218
Mailing Address - Country:US
Mailing Address - Phone:909-395-9676
Mailing Address - Fax:909-395-9687
Practice Address - Street 1:500 N PALM AVE
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91762-3218
Practice Address - Country:US
Practice Address - Phone:909-395-9676
Practice Address - Fax:909-395-9687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-18
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based