1982014379 NPI number — LE REVE HOSPICE, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982014379 NPI number — LE REVE HOSPICE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LE REVE HOSPICE, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1982014379
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/13/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
101 E REDLANDS BLVD
Provider Second Line Business Mailing Address:
STE 242
Provider Business Mailing Address City Name:
REDLANDS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92373-4775
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
909-435-0903
Provider Business Mailing Address Fax Number:
909-748-1805

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
101 E REDLANDS BLVD
Provider Second Line Business Practice Location Address:
STE 242
Provider Business Practice Location Address City Name:
REDLANDS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92373-4775
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
909-435-0903
Provider Business Practice Location Address Fax Number:
909-748-1805
Provider Enumeration Date:
05/07/2014

Additional Information

Authorized Official

Authorized Official Last Name:
ZALSOS
Authorized Official First Name:
CEL ARDEN
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
909-435-0903

Provider Taxonomy Codes

  • Taxonomy code: 251G00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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