Provider Demographics
NPI:1992014062
Name:BRIO ENTERPRISE INCORPORATED
Entity Type:Organization
Organization Name:BRIO ENTERPRISE INCORPORATED
Other - Org Name:BRIO HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SIMONETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:AGUSTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-680-0059
Mailing Address - Street 1:2349 VELLANO CLUB DR
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-6629
Mailing Address - Country:US
Mailing Address - Phone:909-680-0059
Mailing Address - Fax:909-606-4430
Practice Address - Street 1:14712 PIPELINE AVE
Practice Address - Street 2:SUITE C
Practice Address - City:CHINO HILLS
Practice Address - State:CA
Practice Address - Zip Code:91709-1298
Practice Address - Country:US
Practice Address - Phone:909-680-0059
Practice Address - Fax:909-606-4430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-06
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA551673Medicare Oscar/Certification