Provider Demographics
NPI:1740859693
Name:CARITAS HOSPICE CARE INC
Entity type:Organization
Organization Name:CARITAS HOSPICE CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JESUS
Authorized Official - Middle Name:CEBALLOS
Authorized Official - Last Name:CHIONG
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:909-333-7133
Mailing Address - Street 1:517 N MOUNTAIN AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-5016
Mailing Address - Country:US
Mailing Address - Phone:909-333-7133
Mailing Address - Fax:
Practice Address - Street 1:517 N MOUNTAIN AVE STE 203
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-5016
Practice Address - Country:US
Practice Address - Phone:909-333-7133
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-23
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based