Provider Demographics
NPI:1871932525
Name:GBA HOSPICE CARE, INC.
Entity type:Organization
Organization Name:GBA HOSPICE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EVA
Authorized Official - Middle Name:A
Authorized Official - Last Name:ELIZALDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-301-0098
Mailing Address - Street 1:820 N MOUNTAIN AVE STE 107
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-4163
Mailing Address - Country:US
Mailing Address - Phone:909-301-0098
Mailing Address - Fax:909-334-4211
Practice Address - Street 1:820 N MOUNTAIN AVE STE 107
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-4163
Practice Address - Country:US
Practice Address - Phone:909-301-0098
Practice Address - Fax:909-334-4211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-16
Last Update Date:2013-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health