Provider Demographics
NPI:1700461563
Name:SUSTAINABLE HEALTH INITIATIVE INC
Entity Type:Organization
Organization Name:SUSTAINABLE HEALTH INITIATIVE INC
Other - Org Name:INLAND VALLEY HOSPICE & PALLIATIVE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:ARIF
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-225-2721
Mailing Address - Street 1:21809 PAINT BRUSH LN
Mailing Address - Street 2:
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765-2834
Mailing Address - Country:US
Mailing Address - Phone:909-225-2721
Mailing Address - Fax:
Practice Address - Street 1:414 S PROSPECTORS RD STE C2
Practice Address - Street 2:
Practice Address - City:DIAMOND BAR
Practice Address - State:CA
Practice Address - Zip Code:91765-1615
Practice Address - Country:US
Practice Address - Phone:909-225-2721
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-13
Last Update Date:2023-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based