Provider Demographics
NPI:1770933160
Name:HOPE HEALTHCARE SERVICES LLC
Entity type:Organization
Organization Name:HOPE HEALTHCARE SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:JOSEPHINE
Authorized Official - Middle Name:
Authorized Official - Last Name:CRISOSTOMO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:626-864-6871
Mailing Address - Street 1:6600 JURUPA AVE
Mailing Address - Street 2:SUITE 214E
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92504-1041
Mailing Address - Country:US
Mailing Address - Phone:626-864-6871
Mailing Address - Fax:951-346-5520
Practice Address - Street 1:6600 JURUPA AVE
Practice Address - Street 2:SUITE 214E
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92504-1041
Practice Address - Country:US
Practice Address - Phone:626-864-6871
Practice Address - Fax:951-346-5520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-16
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA201423010063251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based