Provider Demographics
NPI:1982236048
Name:HOSPICE SOLACE, INC.
Entity Type:Organization
Organization Name:HOSPICE SOLACE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DPCS/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TIARA
Authorized Official - Middle Name:J
Authorized Official - Last Name:ZALSOS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:909-317-1520
Mailing Address - Street 1:24616 LAWTON AVE
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-3324
Mailing Address - Country:US
Mailing Address - Phone:909-317-1520
Mailing Address - Fax:
Practice Address - Street 1:720 BROOKSIDE AVE STE 104
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-5189
Practice Address - Country:US
Practice Address - Phone:909-317-1520
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-06
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based