Provider Demographics
NPI:1871181701
Name:AMBIANCE CARE HOSPICE
Entity type:Organization
Organization Name:AMBIANCE CARE HOSPICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KENNEDY
Authorized Official - Middle Name:
Authorized Official - Last Name:LAMARIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-267-7692
Mailing Address - Street 1:818 N MOUNTAIN AVE # 203F
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-4167
Mailing Address - Country:US
Mailing Address - Phone:951-267-7692
Mailing Address - Fax:951-254-9900
Practice Address - Street 1:818 N MOUNTAIN AVE # 203F
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-4167
Practice Address - Country:US
Practice Address - Phone:951-267-7692
Practice Address - Fax:951-254-9900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-06
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based