Provider Demographics
NPI:1982142170
Name:EMERALD GARDENS HOSPICE, INC.
Entity Type:Organization
Organization Name:EMERALD GARDENS HOSPICE, INC.
Other - Org Name:BUTTERFLY HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:
Authorized Official - Last Name:MARSHAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-587-9077
Mailing Address - Street 1:600 N MOUNTAIN AVE
Mailing Address - Street 2:C206
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-4359
Mailing Address - Country:US
Mailing Address - Phone:818-000-0000
Mailing Address - Fax:818-000-0000
Practice Address - Street 1:600 N MOUNTAIN AVE STE C206
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-4367
Practice Address - Country:US
Practice Address - Phone:818-000-0000
Practice Address - Fax:818-000-0000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-07
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based