Provider Demographics
NPI:1972909596
Name:IVY HOSPICE CARE, INC.
Entity Type:Organization
Organization Name:IVY HOSPICE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO & ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARGARITA
Authorized Official - Middle Name:SANTIAGO
Authorized Official - Last Name:ARCILLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-931-5090
Mailing Address - Street 1:545 N MOUNTAIN AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-5054
Mailing Address - Country:US
Mailing Address - Phone:909-931-5090
Mailing Address - Fax:909-931-5908
Practice Address - Street 1:545 N MOUNTAIN AVE STE 101
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-5054
Practice Address - Country:US
Practice Address - Phone:909-931-5090
Practice Address - Fax:909-931-5908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-10
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based