Provider Demographics
NPI:1063983997
Name:BETA HOSPICE CARE INC
Entity type:Organization
Organization Name:BETA HOSPICE CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROZA
Authorized Official - Middle Name:
Authorized Official - Last Name:SARGSYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-347-7000
Mailing Address - Street 1:1525 N D ST STE 10
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92405-4774
Mailing Address - Country:US
Mailing Address - Phone:909-347-7000
Mailing Address - Fax:855-563-3575
Practice Address - Street 1:1525 N D ST STE 10
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92405-4774
Practice Address - Country:US
Practice Address - Phone:909-347-7000
Practice Address - Fax:855-563-3575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-17
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1Medicaid