Provider Demographics
NPI:1649614637
Name:EXCELLENCE HOSPICE PROVIDERS, INC.
Entity type:Organization
Organization Name:EXCELLENCE HOSPICE PROVIDERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THI
Authorized Official - Middle Name:
Authorized Official - Last Name:DOAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-590-0348
Mailing Address - Street 1:11760 CENTRAL AVENUE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-1909
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11760 CENTRAL AVENUE
Practice Address - Street 2:SUITE 201
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-1909
Practice Address - Country:US
Practice Address - Phone:909-590-0348
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-22
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based