Provider Demographics
NPI:1982014379
Name:LE REVE HOSPICE, INC.
Entity Type:Organization
Organization Name:LE REVE HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CEL ARDEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZALSOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-435-0903
Mailing Address - Street 1:101 E REDLANDS BLVD
Mailing Address - Street 2:STE 242
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-4775
Mailing Address - Country:US
Mailing Address - Phone:909-435-0903
Mailing Address - Fax:909-748-1805
Practice Address - Street 1:101 E REDLANDS BLVD
Practice Address - Street 2:STE 242
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-4775
Practice Address - Country:US
Practice Address - Phone:909-435-0903
Practice Address - Fax:909-748-1805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-07
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based