Provider Demographics
NPI:1457927493
Name:CLOVER HOSPICE INC
Entity Type:Organization
Organization Name:CLOVER HOSPICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:SARNICULA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-640-1958
Mailing Address - Street 1:1525 3RD ST STE A207
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92507-3440
Mailing Address - Country:US
Mailing Address - Phone:951-460-1277
Mailing Address - Fax:951-460-1287
Practice Address - Street 1:1525 3RD ST STE A207
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92507-3440
Practice Address - Country:US
Practice Address - Phone:951-460-1277
Practice Address - Fax:951-460-1287
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-01
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based