Provider Demographics
NPI:1235799123
Name:RUBICON HOSPICE CARE
Entity type:Organization
Organization Name:RUBICON HOSPICE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ARNOLD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-576-0059
Mailing Address - Street 1:2001 BEVERLY BLVD STE 211
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90057-2403
Mailing Address - Country:US
Mailing Address - Phone:888-576-0059
Mailing Address - Fax:818-600-9250
Practice Address - Street 1:2001 BEVERLY BLVD STE 211
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-2403
Practice Address - Country:US
Practice Address - Phone:888-576-0059
Practice Address - Fax:818-600-9250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-13
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1Medicaid