Provider Demographics
NPI:1750712410
Name:BEAR VALLEY HOSPICE LLC
Entity type:Organization
Organization Name:BEAR VALLEY HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SPENCER
Authorized Official - Middle Name:
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-281-2550
Mailing Address - Street 1:PO BOX 140
Mailing Address - Street 2:
Mailing Address - City:BIG BEAR CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92314-0140
Mailing Address - Country:US
Mailing Address - Phone:909-281-2550
Mailing Address - Fax:909-281-2551
Practice Address - Street 1:909 W BIG BEAR BLVD
Practice Address - Street 2:
Practice Address - City:BIG BEAR CITY
Practice Address - State:CA
Practice Address - Zip Code:92314-9661
Practice Address - Country:US
Practice Address - Phone:909-281-2550
Practice Address - Fax:909-281-2551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-06
Last Update Date:2018-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based