Provider Demographics
NPI:1972831162
Name:ETERNALLY YOURS HOSPICE, INC.
Entity Type:Organization
Organization Name:ETERNALLY YOURS HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CRISTINE
Authorized Official - Middle Name:S
Authorized Official - Last Name:ZAPANTA-CHAVEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-223-9283
Mailing Address - Street 1:2550 E. AMAR RD.
Mailing Address - Street 2:UNIT A1-G
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91792
Mailing Address - Country:US
Mailing Address - Phone:626-965-4200
Mailing Address - Fax:626-965-4230
Practice Address - Street 1:2550 E. AMAR RD.
Practice Address - Street 2:UNIT A1-G
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91792
Practice Address - Country:US
Practice Address - Phone:626-965-4200
Practice Address - Fax:626-965-4200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-26
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based